Challenging cervical spondylodiscitis: Is interventional treatment superior to conservative management?

Abstract

Objective: Cervical spondylodiscitis is a rare spinal infection with limited literature on its management. While antibiotic therapy is critical for infection control, addressing residual pain and functional deficits remains challenging. This retrospective observational study evaluated the efficacy and safety of interventional management in patients with spontaneous cervical spondylodiscitis.

Materials and Methods: Patients were treated with either medical therapy or interventional pain management after completing antibiotic therapy and physical rehabilitation. The outcomes of interventional pain management (Group 1, n=9 ) and medical therapy (Group 2, n= 12) in improving pain, functional capacity, and quality of life in patients with cervical spondylodiscitis were compared. Treatment responses were assessed using Numerical Rating Scale (NRS), Neck Disability Index (NDI), and SF-12 scores before and after therapy. Changes in cervical lordosis angles were also monitored.

Results: Of the 35 screened patients, 21 met the inclusion criteria, with 12 opting for medical therapy and 9 for interventional treatment. Both groups demonstrated significant improvements in NRS, NDI, and SF-12 scores after treatment (p<0.05). Interventional therapy resulted in superior NRS and NDI outcomes compared to medical therapy (NRS: 1.11 vs. 2.33, p=0.017; NDI improvement: 76% vs. 56.66%, p=0.0009). No significant changes in cervical lordosis angles were observed in either group.

Conclusion: Interventional pain management provides superior pain relief and functional improvement compared to medical therapy alone in patients with cervical spondylodiscitis. Conservative management is effective in appropriately selected cases, offering an alternative to surgery for those without instability or neurological deficits.