{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T05:16:20Z","timestamp":1770786980565,"version":"3.50.0"},"reference-count":34,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Background.<\/jats:italic>\n                    \u2014Intervertebral disk tissue is resistant to hematogenous infection because of its avascularity. However, spondylodiskitis is being diagnosed with increasing frequency because of advancement in magnetic resonance imaging technology. There is a dearth of information regarding the bacteriology, histomorphologic features, and radiopathologic correlation of spondylodiskitis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Design.<\/jats:italic>\n                    \u2014The study population consisted of 20 patients diagnosed as having spondylodiskitis by magnetic resonance imaging with and without gadolinium 67 enhancement and bone scans with technetium Tc 99m or gallium citrate Ga 67. Twenty-seven biopsy and debridement specimens were obtained from these patients. The specimens were cultured for microorganisms and also processed for histopathologic testing. Tissue sections were examined with hematoxylin-eosin and stains for infectious agents (Gomori's methenamine-silver, Gram, and Ziehl-Neelsen stains).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results.<\/jats:italic>\n                    \u2014Where intervertebral disk tissue was present (23 of 27 cases), the morphologic changes included vascularization (with or without granulation tissue), myxoid degeneration, and necrosis. Chronic osteomyelitis was present in all 27 specimens and was associated with acute osteomyelitis in 7 cases (25%). Twenty-one of 27 cases had positive culture results (mostly pyogenic bacteria), but special stains revealed microorganisms in sections of the disk in only 4 cases (3 cases with gram-positive cocci and 1 with yeast consistent with\n                    <jats:italic>Blastomyces<\/jats:italic>\n                    ). Florid acute inflammation was present in all the 4 cases.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion.<\/jats:italic>\n                    \u2014Histopathologic features of acute spondylodiskitis include vascular proliferation, myxoid degeneration, and necrosis of the disk tissue with adjacent chronic osteomyelitis. Acute inflammation is variable and when florid is usually associated with identifiable organisms on histologic examination. At biopsy, tissue should be submitted for culture, since culture has a high sensitivity and specificity for detecting the etiologic organism.\n                  <\/jats:p>","DOI":"10.5858\/2000-124-0712-ps","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T20:45:56Z","timestamp":1611866756000},"page":"712-716","source":"Crossref","is-referenced-by-count":40,"title":["Pyogenic Spondylodiskitis"],"prefix":"10.5858","volume":"124","author":[{"given":"Emmanuel","family":"Lucio","sequence":"first","affiliation":[{"name":"From the Departments of Pathology (Drs Lucio, Adesokan, and Adegboyega), Orthopedic Surgery (Dr Hadjipavlou), and Radiology (Dr Crow), University of Texas Medical Branch, Galveston. Dr Adesokan is now with St Barnabas Medical Center, Livingston, New Jersey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adekunle","family":"Adesokan","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology (Drs Lucio, Adesokan, and Adegboyega), Orthopedic Surgery (Dr Hadjipavlou), and Radiology (Dr Crow), University of Texas Medical Branch, Galveston. Dr Adesokan is now with St Barnabas Medical Center, Livingston, New Jersey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander G.","family":"Hadjipavlou","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology (Drs Lucio, Adesokan, and Adegboyega), Orthopedic Surgery (Dr Hadjipavlou), and Radiology (Dr Crow), University of Texas Medical Branch, Galveston. Dr Adesokan is now with St Barnabas Medical Center, Livingston, New Jersey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne N.","family":"Crow","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology (Drs Lucio, Adesokan, and Adegboyega), Orthopedic Surgery (Dr Hadjipavlou), and Radiology (Dr Crow), University of Texas Medical Branch, Galveston. Dr Adesokan is now with St Barnabas Medical Center, Livingston, New Jersey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick A.","family":"Adegboyega","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology (Drs Lucio, Adesokan, and Adegboyega), Orthopedic Surgery (Dr Hadjipavlou), and Radiology (Dr Crow), University of Texas Medical Branch, Galveston. Dr Adesokan is now with St Barnabas Medical Center, Livingston, New Jersey."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","reference":[{"key":"i1543-2165-124-5-712-b1","series-title":"Rev Rhum Mal Osteo","first-page":"401","article-title":"Infectious spondylodiscitis: analysis of a series of 105 cases [in French].","volume":"59","author":"Bontoux, D.","year":"1992","unstructured":"Bontoux, D., F.Codello, F.Debiais, G.Lambert de Cursay, I.Azais, and M.Alcalay. Infectious spondylodiscitis: analysis of a series of 105 cases [in French].Rev Rhum Mal Osteo1992. 59:401\u2013407."},{"key":"i1543-2165-124-5-712-b2","series-title":"Clin Orthop","first-page":"234","article-title":"Pyogenic vertebral osteomyelitis: disk space infections.","volume":"96","author":"Bonfliglio, M.","year":"1973","unstructured":"Bonfliglio, M., T.Lange, and Y. M.Kim. Pyogenic vertebral osteomyelitis: disk space infections.Clin Orthop1973. 96:234\u2013247."},{"key":"i1543-2165-124-5-712-b3","series-title":"J Bone Joint Surg","first-page":"698","article-title":"Pyogenic infections occurring primarily in intervertebral discs.","volume":"55","author":"Kemp, H. B. S.","year":"1973","unstructured":"Kemp, H. B. S., J. W.Jackson, J. D.Jeremiah, and A. J.Hall. Pyogenic infections occurring primarily in intervertebral discs.J Bone Joint Surg1973. 55:698\u2013714."},{"key":"i1543-2165-124-5-712-b4","series-title":"Radiologe","first-page":"291","article-title":"Spondylitis-spondylodiscitis: pathologico-anatomical morphology and diagnostic problems [in German].","volume":"25","author":"Adler, C. P.","year":"1985","unstructured":"Adler, C. P.\n          \n          Spondylitis-spondylodiscitis: pathologico-anatomical morphology and diagnostic problems [in German].\n          Radiologe\n          1985. 25:291\u2013298."},{"key":"i1543-2165-124-5-712-b5","series-title":"Rev Rhum","first-page":"675","article-title":"Spondylodiscites mirobiennes-etude de 60 observations recueillies en 10 ans.","volume":"55","author":"Robert, C.","year":"1988","unstructured":"Robert, C., J. C.Renier, and M.Audran. et al. Spondylodiscites mirobiennes-etude de 60 observations recueillies en 10 ans.Rev Rhum1988. 55:675\u2013682."},{"key":"i1543-2165-124-5-712-b6","series-title":"Rhumatologie","first-page":"1477","article-title":"Diagnosis of infectious spondylodiscitis.","volume":"30","author":"Gougeon, J.","year":"1980","unstructured":"Gougeon, J.\n          \n          Diagnosis of infectious spondylodiscitis.\n          Rhumatologie\n          1980. 30:1477\u20131482."},{"key":"i1543-2165-124-5-712-b7","series-title":"Rev Praticien","first-page":"1073","article-title":"Microbial spondylodiscitis: etiology, diagnosis, course and prognosis, principles of treatment.","volume":"39","author":"Dubost, J.","year":"1989","unstructured":"Dubost, J., R.Lopitaux, and S.Rampon. Microbial spondylodiscitis: etiology, diagnosis, course and prognosis, principles of treatment.Rev Praticien1989. 39:1073\u20131076."},{"key":"i1543-2165-124-5-712-b8","series-title":"Rev Praticien","first-page":"1299","article-title":"Bacterial spondylodiscitis: etiology, diagnosis, course, prognosis and treatment [in French].","volume":"42","author":"Bussiere, J. L.","year":"1992","unstructured":"Bussiere, J. L.\n          \n          Bacterial spondylodiscitis: etiology, diagnosis, course, prognosis and treatment [in French].\n          Rev Praticien\n          1992. 42:1299\u20131302."},{"key":"i1543-2165-124-5-712-b9","series-title":"Neurosurgery","first-page":"926","article-title":"Neurosurgical management of thoracic and lumbar vertebral osteomyelitis and discitis in adults: a review of 43 consecutive surgically treated patients.","volume":"38","author":"Rath, S. A.","year":"1996","unstructured":"Rath, S. A., U.Neff, O.Schneider, and H. P.Richter. Neurosurgical management of thoracic and lumbar vertebral osteomyelitis and discitis in adults: a review of 43 consecutive surgically treated patients.Neurosurgery1996. 38:926\u2013933."},{"key":"i1543-2165-124-5-712-b10","series-title":"Infect Dis Clin N Am","first-page":"539","article-title":"Vertebral osteomyelitis.","volume":"4","author":"Sapico, F. L.","year":"1990","unstructured":"Sapico, F. L. and J. Z.Montgomerie. Vertebral osteomyelitis.Infect Dis Clin N Am1990. 4:539\u2013550."},{"key":"i1543-2165-124-5-712-b11","series-title":"Aktuelle Radiol","first-page":"308","article-title":"Infections of the spine [in German].","volume":"6","author":"Heindel, W.","year":"1996","unstructured":"Heindel, W., H.Lanfermann, R.du Mesnil, and R.Fischback. Infections of the spine [in German].Aktuelle Radiol1996. 6:308\u2013316."},{"key":"i1543-2165-124-5-712-b12","series-title":"Spine","first-page":"780","article-title":"The clinical use of magnetic resonance imaging in pyogenic vertebral osteomyelitis.","volume":"22","author":"Carragee, E. J.","year":"1997","unstructured":"Carragee, E. J.\n          \n          The clinical use of magnetic resonance imaging in pyogenic vertebral osteomyelitis.\n          Spine\n          1997. 22:780\u2013785."},{"key":"i1543-2165-124-5-712-b13","series-title":"South Med J","first-page":"347","article-title":"A study of acute infectious lesions of the intervertebral disks.","volume":"33","author":"Ghormley, R. K.","year":"1940","unstructured":"Ghormley, R. K., W. H.Bickel, and D. D.Dickson. A study of acute infectious lesions of the intervertebral disks.South Med J1940. 33:347\u2013352."},{"key":"i1543-2165-124-5-712-b14","series-title":"Spine","first-page":"284","article-title":"Treatment of hematogenous pyogenic vertebral osteomyelitis with anterior debridement and primary bone grafting.","volume":"14","author":"Emery, S. E.","year":"1989","unstructured":"Emery, S. E., D. P.Chan, and H. R.Woodward. Treatment of hematogenous pyogenic vertebral osteomyelitis with anterior debridement and primary bone grafting.Spine1989. 14:284\u2013291."},{"key":"i1543-2165-124-5-712-b15","series-title":"Am J Orthop","first-page":"188","article-title":"Percutaneous transpedicular discectomy and drainage in pyogenic spondylodiscitis.","volume":"27","author":"Hadjipavlou, A. G.","year":"1998","unstructured":"Hadjipavlou, A. G., W. N.Crow, A.Borowski, J. T.Mader, A.Adesokan, and R. E.Jensen. Percutaneous transpedicular discectomy and drainage in pyogenic spondylodiscitis.Am J Orthop1998. 27:188\u2013197."},{"key":"i1543-2165-124-5-712-b16","series-title":"Clin Infect Dis","first-page":"320","article-title":"Pyogenic vertebral osteomyelitis: analysis of 20 cases and review.","volume":"20","author":"Torda, A. J.","year":"1995","unstructured":"Torda, A. J., T.Gottlieb, and R.Bradbury. Pyogenic vertebral osteomyelitis: analysis of 20 cases and review.Clin Infect Dis1995. 20:320\u2013328."},{"key":"i1543-2165-124-5-712-b17","series-title":"J Bone Joint Surg Br","first-page":"26","article-title":"Discitis after discography.","volume":"68","author":"Fraser, R. D.","year":"1987","unstructured":"Fraser, R. D. and O. L.Osti. Discitis after discography.J Bone Joint Surg Br1987. 68:26\u201335."},{"key":"i1543-2165-124-5-712-b1","series-title":"Rev Rhum Mal Osteo","first-page":"401","article-title":"Infectious spondylodiscitis: analysis of a series of 105 cases [in French].","volume":"59","author":"Bontoux, D.","year":"1992","unstructured":"Bontoux, D., F.Codello, F.Debiais, G.Lambert de Cursay, I.Azais, and M.Alcalay. Infectious spondylodiscitis: analysis of a series of 105 cases [in French].Rev Rhum Mal Osteo1992. 59:401\u2013407."},{"key":"i1543-2165-124-5-712-b2","series-title":"Clin Orthop","first-page":"234","article-title":"Pyogenic vertebral osteomyelitis: disk space infections.","volume":"96","author":"Bonfliglio, M.","year":"1973","unstructured":"Bonfliglio, M., T.Lange, and Y. M.Kim. Pyogenic vertebral osteomyelitis: disk space infections.Clin Orthop1973. 96:234\u2013247."},{"key":"i1543-2165-124-5-712-b3","series-title":"J Bone Joint Surg","first-page":"698","article-title":"Pyogenic infections occurring primarily in intervertebral discs.","volume":"55","author":"Kemp, H. B. S.","year":"1973","unstructured":"Kemp, H. B. S., J. W.Jackson, J. D.Jeremiah, and A. J.Hall. Pyogenic infections occurring primarily in intervertebral discs.J Bone Joint Surg1973. 55:698\u2013714."},{"key":"i1543-2165-124-5-712-b4","series-title":"Radiologe","first-page":"291","article-title":"Spondylitis-spondylodiscitis: pathologico-anatomical morphology and diagnostic problems [in German].","volume":"25","author":"Adler, C. P.","year":"1985","unstructured":"Adler, C. P.\n          \n          Spondylitis-spondylodiscitis: pathologico-anatomical morphology and diagnostic problems [in German].\n          Radiologe\n          1985. 25:291\u2013298."},{"key":"i1543-2165-124-5-712-b5","series-title":"Rev Rhum","first-page":"675","article-title":"Spondylodiscites mirobiennes-etude de 60 observations recueillies en 10 ans.","volume":"55","author":"Robert, C.","year":"1988","unstructured":"Robert, C., J. C.Renier, and M.Audran. et al. Spondylodiscites mirobiennes-etude de 60 observations recueillies en 10 ans.Rev Rhum1988. 55:675\u2013682."},{"key":"i1543-2165-124-5-712-b6","series-title":"Rhumatologie","first-page":"1477","article-title":"Diagnosis of infectious spondylodiscitis.","volume":"30","author":"Gougeon, J.","year":"1980","unstructured":"Gougeon, J.\n          \n          Diagnosis of infectious spondylodiscitis.\n          Rhumatologie\n          1980. 30:1477\u20131482."},{"key":"i1543-2165-124-5-712-b7","series-title":"Rev Praticien","first-page":"1073","article-title":"Microbial spondylodiscitis: etiology, diagnosis, course and prognosis, principles of treatment.","volume":"39","author":"Dubost, J.","year":"1989","unstructured":"Dubost, J., R.Lopitaux, and S.Rampon. Microbial spondylodiscitis: etiology, diagnosis, course and prognosis, principles of treatment.Rev Praticien1989. 39:1073\u20131076."},{"key":"i1543-2165-124-5-712-b8","series-title":"Rev Praticien","first-page":"1299","article-title":"Bacterial spondylodiscitis: etiology, diagnosis, course, prognosis and treatment [in French].","volume":"42","author":"Bussiere, J. L.","year":"1992","unstructured":"Bussiere, J. L.\n          \n          Bacterial spondylodiscitis: etiology, diagnosis, course, prognosis and treatment [in French].\n          Rev Praticien\n          1992. 42:1299\u20131302."},{"key":"i1543-2165-124-5-712-b9","series-title":"Neurosurgery","first-page":"926","article-title":"Neurosurgical management of thoracic and lumbar vertebral osteomyelitis and discitis in adults: a review of 43 consecutive surgically treated patients.","volume":"38","author":"Rath, S. A.","year":"1996","unstructured":"Rath, S. A., U.Neff, O.Schneider, and H. P.Richter. Neurosurgical management of thoracic and lumbar vertebral osteomyelitis and discitis in adults: a review of 43 consecutive surgically treated patients.Neurosurgery1996. 38:926\u2013933."},{"key":"i1543-2165-124-5-712-b10","series-title":"Infect Dis Clin N Am","first-page":"539","article-title":"Vertebral osteomyelitis.","volume":"4","author":"Sapico, F. L.","year":"1990","unstructured":"Sapico, F. L. and J. Z.Montgomerie. Vertebral osteomyelitis.Infect Dis Clin N Am1990. 4:539\u2013550."},{"key":"i1543-2165-124-5-712-b11","series-title":"Aktuelle Radiol","first-page":"308","article-title":"Infections of the spine [in German].","volume":"6","author":"Heindel, W.","year":"1996","unstructured":"Heindel, W., H.Lanfermann, R.du Mesnil, and R.Fischback. Infections of the spine [in German].Aktuelle Radiol1996. 6:308\u2013316."},{"key":"i1543-2165-124-5-712-b12","series-title":"Spine","first-page":"780","article-title":"The clinical use of magnetic resonance imaging in pyogenic vertebral osteomyelitis.","volume":"22","author":"Carragee, E. J.","year":"1997","unstructured":"Carragee, E. J.\n          \n          The clinical use of magnetic resonance imaging in pyogenic vertebral osteomyelitis.\n          Spine\n          1997. 22:780\u2013785."},{"key":"i1543-2165-124-5-712-b13","series-title":"South Med J","first-page":"347","article-title":"A study of acute infectious lesions of the intervertebral disks.","volume":"33","author":"Ghormley, R. K.","year":"1940","unstructured":"Ghormley, R. K., W. H.Bickel, and D. D.Dickson. A study of acute infectious lesions of the intervertebral disks.South Med J1940. 33:347\u2013352."},{"key":"i1543-2165-124-5-712-b14","series-title":"Spine","first-page":"284","article-title":"Treatment of hematogenous pyogenic vertebral osteomyelitis with anterior debridement and primary bone grafting.","volume":"14","author":"Emery, S. E.","year":"1989","unstructured":"Emery, S. E., D. P.Chan, and H. R.Woodward. Treatment of hematogenous pyogenic vertebral osteomyelitis with anterior debridement and primary bone grafting.Spine1989. 14:284\u2013291."},{"key":"i1543-2165-124-5-712-b15","series-title":"Am J Orthop","first-page":"188","article-title":"Percutaneous transpedicular discectomy and drainage in pyogenic spondylodiscitis.","volume":"27","author":"Hadjipavlou, A. G.","year":"1998","unstructured":"Hadjipavlou, A. G., W. N.Crow, A.Borowski, J. T.Mader, A.Adesokan, and R. E.Jensen. Percutaneous transpedicular discectomy and drainage in pyogenic spondylodiscitis.Am J Orthop1998. 27:188\u2013197."},{"key":"i1543-2165-124-5-712-b16","series-title":"Clin Infect Dis","first-page":"320","article-title":"Pyogenic vertebral osteomyelitis: analysis of 20 cases and review.","volume":"20","author":"Torda, A. J.","year":"1995","unstructured":"Torda, A. J., T.Gottlieb, and R.Bradbury. Pyogenic vertebral osteomyelitis: analysis of 20 cases and review.Clin Infect Dis1995. 20:320\u2013328."},{"key":"i1543-2165-124-5-712-b17","series-title":"J Bone Joint Surg Br","first-page":"26","article-title":"Discitis after discography.","volume":"68","author":"Fraser, R. D.","year":"1987","unstructured":"Fraser, R. D. and O. L.Osti. 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