Evaluating the Role of Conservative Therapy in Cervical Spondylodiscitis: Efficacy of Medical Versus Interventional Pain Treatments

Background and Objective: Spondylodiscitis is a severe infection of the spinal discs, often leading to significant morbidity and mortality. The cervical spine is a rare site for this condition due to better blood and lymphatic supply. The primary treatment goal is infection control through long-term antibiotherapy, followed by pain and functional restoration via medical, physical, and interventional therapies. Surgery is reserved for cases with progressive neurologic deficits or severe instability. Methods This retrospective study, approved by the Clinical Research Ethics Committee, included patients diagnosed with cervical spondylodiscitis from December 2017 to January 2023. Exclusions were thoracic/lumbar spondylodiscitis, malignancy history, severe deformities, progressive neurologic deficits, or incomplete data. Diagnosis was based on multidisciplinary evaluations, clinical history, physical examination, and various laboratory and imaging tests. Patients were divided into two groups: those receiving interventional pain treatments (Group 1) and those receiving medical pain treatments (Group 2). Results Out of 132 patients, 21 met inclusion criteria. The average age was 58.33 years, with a mean follow-up of 28.80 months. Interventional treatments showed superior pain reduction (NRS: 1.11 vs. 2.33, p = 0.017) and greater improvement in Neck Disability Index (NDI: 76% vs. 56.66%, p = 0.0009) compared to medical treatments. Both groups showed significant improvements in SF-12 scores and disability percentages, with no significant difference in cervical lordosis angles post-treatment. Conclusion Both medical and interventional pain treatments post-antibiotic therapy effectively improve pain, disability, and quality of life in cervical spondylodiscitis patients. Interventional treatments, targeting the pain source, may offer greater benefits. Further prospective studies are necessary to validate these findings and refine treatment approaches. Surgery remains crucial for select patients with specific indications.