Table 2 Clinical and etiological characteristics of included studies

Yagdiran A.,et al.2022

Reduced ability or inability to walk or sit (70%), limp (60%), back pain (50%), abdominal pain (10%), fever (10%)

Thoracic spine (10%), lumbar spine (90%)

9.2 weeks

CRP elevation (60%), ESR elevation (50%), anemia (10%)

Negative blood cultures (100%),

Biopsy: M.tuberculosis (10%), MSSA (10%)

X-rays: narrowing of intervertebral disk (50%)

MRI: reduced disk height, disk hypointensity on T1, and disk hyperintensity on T2 (100%)

1.5 months follow-up: destruction of vertebral body (70%), psoas abscess (40%),

paraspinal abscess (30%)

Antibiotics (100%) for 5.2 weeks, surgical intervention (20%)

Ferri I.,et al.2021

Reduced range of movement (66.6%), back pain (49.8%),

limp (19%), fever (33.3%), reduced ability or inability to walk or sit (14.2%),

neurological sign (4.7%), torticollis (4.7%),

Cervical spine (10%), thoracic spine (20%),

lumbar spine (60%),

sacral (10%)

1.4 weeks

ESR elevation (85.7%), leukocytosis (33.3%), CRP elevation (19%)

Positive blood culture and biopsy: S.aureus (28.6%)

X-ray: reduction of lumbar lordosis, loss of disk height (22.4%)

MRI: disk hypo intensity on T1, and disk hyper intensity on T2 (100%), subperiosteally and muscular abscess (14.3%)

12 months follow-up:

back pain (25%), kyphosis (10%)

Antibiotics (100%) for 4weeks,

immobilization (bracing) (57.1%),

surgical intervention (4.75%)

Musso P.,et al.2021

Back pain (72.7%), reduced range of movement (72.7%), fever (31.8%), swelling (4.5%)

Cervical spine (13.8%), thoracic spine (13.8%),

lumbosacral spine (72.4%)

1.7 weeks

ESR elevation (100%), CRP elevation (77.8%), leukocytosis (19.5%)

Positive blood culture:

S.aureus (13.6%),

E.coli (4.5%), S.agalactiae (4.5%)

X-rays: narrowing of intervertebral disk (100%)

MRI and CT scan: Subperiosteally abscess (4.5%), muscular abscess (9%)

Follow-up:

Reduced range of movement (5%)

Antibiotics (100%) for 7weeks, surgical intervention (4.5

%)

Roversi.M.,et al.2021

Back pain (96%), fever (46%)

limp (10%)

Cervical spine (6.5%), thoracic spine (24.5%), lumbar spine (44%), lumbosacral (25%)

3weeks

ESR elevation (100%), CRP elevation (in few cases)

Positive blood culture:

S.aureus (10.4%), M.tuberculosis (14.3%), K. kingae (8.3%)

X-rays: narrowing of intervertebral disk (96%)

MRI and CT scan: Involvement of adjacent vertebral endplate (33%), soft tissue abscess (33%), Cellulitis or myositis (15%)

12.5 months follow-up:

kyphosis (10.4%), scoliosis (4.1%), gibbus (2%), rigidity (2%)

Antibiotics (100%) for 6 weeks,

immobilization (cast braces) for16weeks (100%)

Afshari F.,et al.2019

reduced ability or inability to walk or sit (57%), back pain (52%), fever (14%), limp (10%)

Cervical spine (4.7%), thoracic spine (4.7%), lumbar spine (90.6%)

6 weeks

ESR elevation (66.6%), CRP elevation (38%), leucocytosis (9.5%)

Positive blood culture:

S.aureus (4.75%), mixed E. coli and M.morganii (4.75%),

Biopsy: S.aureus (one case)

X-rays: narrowing intervertebral disc (100%)

MRI: abnormal disc signal (100%), epidural spinal collection (4.76%)

20 months follow- up: back pain (19%)

Antibiotic (100%) for 9.3 weeks, no surgery management

Dayer R.,et al. 2018

Fever (36%), reduced general condition (36%)

Cervical spine (6%), thoracic spine (18%), lumbar spine (70%), sacral (6%)

4weeks

ESR elevation (86%), thrombocytosis (63%), CRP elevation (58%), leukocytosis (41%)

Positive blood culture:

S.aureus (6%), K. kingae (2%)

Biopsy (7.7%): S.aureus, K. kingae, L.lactis

X-rays: narrowing intervertebral disk (100%)

MRI: low signal intensity on T1, a loss of definition of the endplate and of the adjacent vertebral bodies, and high signal intensity on T2 (100%),

Vertebral osteomyelitis (29%)

N.A.

Antibiotic (100%), no surgical management

Kang H.,et al.2016

Back pain (68%), fever (52%), reduced ability or inability to walk or sit (62.5%), abdominal pain (20%), neurological sign (12%)

Cervical spine (8%), thoracic spine (16%), lumbar spine (72%)

sacral (4%)

6.4 weeks

ESR elevation,

CRP elevation, and leukocytosis

(in most cases)

Positive blood culture and biopsies:

S.aureus (40%), M.tuberculosis (32%), E.coli (8%), S.pneumonia (4%), S.typhi (4%)

X-rays: destruction of vertebral body (80%), disk involvement (100%)

MRI and CT scan: disk involvement (100%), involvement of adjacent vertebral body (76%), paravertebral abscess (23.5%)

60 months follow-up: kyphosis (8%), scoliosis (8%), back pain (4%)

Antibiotic (100%) for 6-61weeks,

surgical intervention (48%)

Ceroni D.,et al.2013

Fever (90%)

Lumbar spine (100%)

4.2 weeks

ESR elevation (90%), CRP elevation (60%)

thrombocytosis (70%)

Negative blood cultures (100%),

MRI: abnormal disc signal (100%), abnormal signal in adjacent vertebral body with bone abscess (60%), epidural abscess (20%)

48 months follow-up: no evidence of complications

Antibiotics (100%), no surgical management

Zomalheto Z.,et al.2013

Back pain (72.4%), weight loss (72.4%), fever (58.6%), anorexia (41.3%), neurological sign (7%)

Thoracic spine (27.6%), lumbar spine (72.4%)

6.5 weeks

ESR elevation (100%), CRP elevation (100%), leukocytosis (100%)

Positive blood culture: M.tuberculosis (72.4%),

S.aureus (4.76%), E.coli (14.28%), K.pneumonia (4.76%), Salmonella spp. (4.76%)

N.A.

10 months follow-up: kyphosis (31%), neurological complications (31%)

Antibiotics (100%), and

immobilization (100%) for 12weeks,

no surgical management

Spencer S.,et al.2012

Limp (70%), back pain (70%), abdominal pain (20%)

Lumbar spine (100%)

3.1weeks

ESR elevation (100%), CRP elevation (16%), leukocytosis (16%)

Positive blood culture: Gram positive Cocci(17%)

X-rays: narrowing of intervertebral disc height (100%)

Bone scan: increase uptake at effected disk (100%)

scan: demonstrating intervertebral disc involvement (100%), abscess (16%), epidural collection (8%)

13.3 months follow up: no evidence of complications

Antibiotics (100%) for 6 weeks, no surgical management

Chandrasenan J.,et al. 2011

Reduced ability or inability to walk or sit (56%), fever (37.5%), back pain (31.5%), reduced range of movement (31%), reduced general condition (12.5%),

abdominal pain (6.25%)

Thoracic spine (37.5%), lumbar spine (62.5%)

2.5weeks

ESR elevation (87.5%), CRP elevation (50%), leukocytosis (31.25%)

Positive blood culture:

S.aureus (31.2%), S.epidermis (6.2%), S.pneumonia (6.2%)

X-rays: narrowing of intervertebral space (100%), sclerosis and fusion of the vertebra or ankyloses (50%), Bone scan: increase uptake at effected disk and adjacent vertebral bodies (25%)

MRI: abnormal disc signal (75%)

24 months follow-up: restrictions in spinal movements ( 20%), disk degeneration (37.5%)

Antibiotics (87.5%), immobilization (bracing) (37.5%), no surgical management

Miranda.I.,et al.2008

Reduced ability or inability to walk or sit (70%),back pain (80%), fever (30%)

Cervical spine (10%), lumbar spine (90%)

3.7 ± 0.6 weeks

ESR elevation (100%), CRP elevation (80%), leukocytosis (80%)

N.A.

X-rays: reduction of the intervertebral space, and irregularity of the vertebral (40%)

MRI: abnormal disc signal (100%), paravertebral abscess (60%)

156 months follow-up: sclerosis, osteophytes, and reduction of intervertebral space (80%)

Antibiotics (100%) for 11weeks, immobilization for 21.2 weeks, no surgical management

Waizy H.,et al.2007

Limp, and reduced ability or inability to walk or sit (100%), back pain (83%), abdominal pain (16%), fever (16%)

Thoracic spine (16%), thoracolumbar spine (33%), lumbar spine (50%)

3.5weeks

ESR elevation (100%)

Negative blood cultures (100%)

X-rays: decreased height of disk space, erosions of adjacent vertebral endplate (100%)

MRI: abnormal disc signal (100%)

31 months follow-up: sclerotic vertebral endplates or partial fusion (few cases)

Antibiotics (100%) for 3 weeks, immobilization (100%) (cast or corset) for 40 weeks,

no surgical management

Kayser R.,et al.2005

Fever (100%), reduced range of movement (88%), back pain (76%),

reduced ability or inability to walk or sit (44%), reduced general condition (28%)

Cervical spine (4%), thoracic spine (36%), lumbar spine (60%)

14 weeks

ESR elevation (84%)

Negative blood cultures (100%)

X-rays: disc space narrowing (100%), destruction of adjacent vertebral bodies (48%), isolated disc involvement (52%)

CT scan and bone scan: inflammatory changes in the affected regions (16%), abscess (4%)

120 months follow up: fibrous ankylosis and high-grade narrowing of the intervertebral disc space(60%), fusion of the vertebra (40%), restricted spinal movement and local kyphosis(20%), residual defects (20%)

Antibiotics and immobilization (a plaster bed or cast or brace) (100%) for 16–80 weeks,

no surgical management

Karabouta Z., et al. 2005

Reduced ability or inability to walk or sit (100%), back pain (100%), abdominal pain (60%), limp (20%), reduced range of movement (20%), fever (20%)

Lumbar spine (100%)

4 weeks

Normal ESR, CRP, and blood counts

Negative blood cultures (100%)

X-ray: disc space narrowing and irregular end plates of vertebrae (80%)

MRI: abnormal disc signal (100%), paravertebral mass (20%)

3 months follow –up: no evidence of complications

Antibiotic (100%), no surgical management

Garron E.,et al. 2002

Fever(60%), back pain (50%), limp (38%), reduced ability or inability to walk or sit (21%), abdominal pain (10%), neurological signs (10%)

Cervical spine (7%), thoracic spine (21.4%), lumbar spine (71.6%)

6weeks

ESR elevation (71%), CRP elevation (50%), leukocytosis (50%)

Positive blood culture and biopsies: C.burnetii (3cases)

FNA: S.aureus (55%), K.kingae (27%)

X-rays: narrowing of intervertebral disk and destruction of adjacent vertebral endplate (100%)

MRI and CT scan: perispinal abscess (37%), epidural thickening (19%)

Bone scan: increase uptake at effected disk and adjacent vertebral bodies (61%)

52.8 months follow-up: kyphosis (16%), pain in activities (7%), limited neck mobility (2%), neural sequelae (2%),

Antibiotics and immobilization (collar and brace) (100%), surgical intervention (9.5%)

Brown.R.,et al.2001

Reduced ability or inability to walk or sit (63%), inability to flex the lower back(50%), loss of lordosis (40%), back pain (27%), neurological signs(9%)

Lumbar spine (100%)

3.4weeks

ESR elevation (100%), leukocytosis (64%),

CRP elevation (40%),

Negative blood cultures (100%),

Biopsy: inflammatory cells (18%)

X-rays: narrowing of intervertebral disk (55%),

MRI: reduced disk height, abnormal disc signal (72%), destruction of endplates or protrusion of the disc (55%), paraspinal mass (27%)

34 months follow up: kyphosis (9%), osseous fusion (18%), posterior wedging (9%)

Antibiotics (100%) for 2–42 weeks, immobilization (45%) (brace) for 11 weeks, no surgical management