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Clinical, radiological, and microbiological data analysed, multivariate logistic regression assessed risk factors for poor outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence of IS was 3 cases per 100,000 inhabitants per year. Pyogenic infections accounted for 54% of cases, tuberculosis for 10%, while 35% remained of unknown etiology. Back pain (79%) and fever (72%) were the most common symptoms.\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      was the most common pathogen, with 34 cases, representing 64% of pyogenic spondylodiscitis. Blood cultures were positive in 47% of pyogenic cases, 25% of all cases. PET\/CT showed higher diagnostic utility (83%) than labeled leukocyte scintigraphy (54%). The lumbar spine was the most affected region (63%), followed by thoracic (25%) and cervical (12%). Neurosurgical biopsy showed a 33.3% positivity rate, while CT-guided biopsy yielded 22%. Cervical (OR 4.76) and thoracic (OR 3.89) involvement were associated with worse outcomes. Major complications included radicular nerve damage (51%), epidural\/paravertebral abscesses (45%), endocarditis (14%), and a need for surgical intervention in 8%, with persistent neurological sequelae in 3%. Infection-related mortality rate was 6%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:italic>S. aureus<\/jats:italic>\n                      remains the leading pathogen in IS. Blood cultures play a key role, yielding positive in half of pyogenic cases. PET\/CT surpassed leukocyte scintigraphy and improved MRI diagnostic accuracy. Lumbar involvement correlates with better outcomes, and open biopsy provides a higher diagnostic yield than percutaneous TC-guided biopsy. Empirical therapy is required in one-third of cases.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10096-025-05292-5","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T18:55:30Z","timestamp":1759172130000},"page":"3067-3078","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Infectious spondylodiscitis: Epidemiology, diagnosis, microbiological findings, clinical features and outcomes in a 14-year retrospective study"],"prefix":"10.1007","volume":"44","author":[{"given":"Jacopo","family":"Conti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Geremia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6121-7009","authenticated-orcid":false,"given":"Stefano","family":"Di Bella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulvio","family":"Zadra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Zerbato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Babich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venera","family":"Costantino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Di Santolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Busetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Mearelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonello","family":"Tacconi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Francesco Maria","family":"Cavallaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Assunta","family":"Cova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianni","family":"Biolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Luzzati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Giacomazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"5292_CR1","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.1302\/0301-620X.87B11.16294","volume":"87","author":"S Govender","year":"2005","unstructured":"Govender S (2005) Spinal infections. 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