{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T23:50:46Z","timestamp":1781913046786,"version":"3.54.5"},"reference-count":7,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Approaches to the diagnosis and treatment of pyogenic spondylodiscitis vary significantly across German-speaking countries. To assess current clinical practice and compare it with prior data, a survey was conducted following the publication of the 2020 S2k guideline on the diagnosis and treatment of spondylodiscitis.<\/jats:p>\n                  <jats:p>A standardized and anonymized 32-item online questionnaire was distributed to members of the German Spine Society (DWG) between April and September 2021. The survey evaluated diagnostic workflows, therapeutic strategies, and guideline adherence in Germany, Austria, and Switzerland (DACH region). Findings were compared with data from a similar survey conducted in 2014.<\/jats:p>\n                  <jats:p>A total of 220 respondents completed the survey; 36% worked in certified spine centres. Decisions regarding diagnosis and treatment were most frequently made during internal team meetings (60.3%) or by senior physicians (59.3%). Interdisciplinary case conferences were held in 30.8% of hospitals. Two-thirds of respondents reported the use of standardized operating procedures (SOPs), and 75.2% had integrated the current guideline into clinical routines.Diagnostic procedures were largely standardized: 98% performed focused history taking and source identification. Common investigations included echocardiography, urinalysis, chest X-ray, and whole-spine MRI\u2014all used by over 80% of respondents. In more than 85% of cases, diagnosis was based on imaging, CRP levels, and clinical symptoms, followed by microbiological confirmation.In conservative treatment settings, targeted antibiotic therapy was initiated after pathogen identification in 74% of cases; in surgically\n        managed cases, this occurred in 36%. Sepsis and fever were the most common reasons for empirical (non-targeted) therapy. The most frequently used empirical agents were clindamycin (41.6%) and ampicillin\/sulbactam (28.3%).<\/jats:p>\n                  <jats:p>Initial treatment was administered intravenously for at least two weeks in 85.2% of cases, followed by oral therapy for a total duration of 6\u201312 weeks in 83%. Therapy duration \u2264\u00a06 weeks was reported by 10.1%. Biofilm-active antibiotics were used in 49.3% of cases\u2014especially when foreign material was present (59.8%) or newly implanted (50.2%).Emergency surgery was most often triggered by neurological deficits and epidural abscesses. Titanium was the most frequently used material for defect reconstruction (81%). Locally applied antibiotics included gentamicin (66.2%) and vancomycin (57.9%). Orthotic bracing was prescribed by 67.7% of respondents during conservative treatment.Notable differences between certified and non-certified institutions were found in the selection of empirical antibiotics and the use of locally applied agents.<\/jats:p>\n                  <jats:p>Since the last survey in 2014, clinical management of spondylodiscitis in the DACH region has shown increased standardization, particularly in diagnostic procedures and guideline implementation. However, variability remains in empirical antibiotic selection and the use of local antimicrobial therapy, underlining the need for further harmonization of treatment strategies.<\/jats:p>","DOI":"10.1055\/a-2763-9240","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:39:50Z","timestamp":1771375190000},"page":"237-243","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis and Treatment of Nonspecific Spondylodiscitis in Adults in Germany, Austria, and Switzerland (DACH): Analysis of an Online Survey"],"prefix":"10.1055","volume":"164","author":[{"given":"Nicolas H.","family":"von der H\u00f6h","sequence":"additional","affiliation":[{"name":"Universit\u00e4t Leipzig Medizinische Fakult\u00e4t, Deutschland","place":["Leipzig"],"department":["Klinik und Poliklinik f\u00fcr Orthop\u00e4die, Unfallchirurgie und Plastische Chirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Herren","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Aachen, NRW, Deutschland","place":["Aachen"],"department":["Klinik f\u00fcr Unfall- und Wiederherstellungschirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max J.","family":"Scheyerer","sequence":"additional","affiliation":[{"name":"Heinrich-Heine-Universit\u00e4t D\u00fcsseldorf, NRW, Deutschland","place":["D\u00fcsseldorf"],"department":["Klinik f\u00fcr Orthop\u00e4die und Unfallchirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin","family":"Quack","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Aachen, NRW, Deutschland","place":["Aachen"],"department":["Klinik f\u00fcr Unfall- und Wiederherstellungschirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Drange","sequence":"additional","affiliation":[{"name":"Klinikum Magdeburg, Zentrum f\u00fcr Unfallchirurgie und Orthop\u00e4die, Deutschland","place":["Magdeburg"],"department":["Wirbels\u00e4ulenchirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3373","DOI":"10.3390\/jcm12103373","article-title":"The Epidemiology of Spondylodiscitis in Germany: A Descriptive Report of Incidence Rates, Pathogens, In-Hospital Mortality, and Hospital Stays between 2010 and 2020","volume":"12","author":"S Lang","year":"2023","journal-title":"J Clin Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e227","DOI":"10.1017\/S0950268821002181","article-title":"Large increase of vertebral osteomyelitis in France: a 2010\u20132019 cross-sectional study","volume":"149","author":"Y Conan","year":"2021","journal-title":"Epidemiol Infect"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.bas.2023.101733","article-title":"Increasing incidence of spondylodiscitis in England: An analysis of the national health service (NHS) hospital episode statistics from 2012 to 2021","volume":"3","author":"SG Thavarajasingam","year":"2023","journal-title":"Brain Spine"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-47341-z","article-title":"Epidemiological trends of pyogenic spondylodiscitis in Germany: an EANS Spine Section Study","volume":"13","author":"A Kramer","year":"2023","journal-title":"Sci Rep"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1038\/s41591-019-0675-0","article-title":"Chronic inflammation in the etiology of disease across the life span","volume":"25","author":"D Furman","year":"2019","journal-title":"Nat Med"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.15252\/embr.202051034","article-title":"Antibiotic resistance and persistence \u2013 Implications for human health and treatment perspectives","volume":"21","author":"M Huemer","year":"2020","journal-title":"EMBO Rep"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1055\/s-0034-1383131","article-title":"[Current treatment strategies for spondylodiscitis in surgical clinics in Germany]","volume":"152","author":"V Quack","year":"2014","journal-title":"Z Orthop Unfall"}],"container-title":["Zeitschrift f\u00fcr Orthop\u00e4die und Unfallchirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2763-9240.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T22:54:44Z","timestamp":1781909684000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2763-9240"}},"subtitle":["Online Survey on the Treatment of Spondylodiscitis (DACH)"],"short-title":[],"issued":{"date-parts":[[2026,2,17]]},"references-count":7,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,6,19]]},"published-print":{"date-parts":[[2026,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2763-9240","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1864-6697","1864-6743"],"issn-type":[{"value":"1864-6697","type":"print"},{"value":"1864-6743","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,17]]}}}