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A rational program of diagnosis and therapy can be recommended on the basis of the results in a series of 34 cases of pyogenic vertebral osteomyelitis. The diagnosis can be made on history, physical examination, sedimentation rate, bone scan and X-ray. Blood and urine cultures should be done and may be of value. Biopsy of the area confirms the diagnosis and establishes adequate and specific antibiotic therapy. Bed rest is needed to relieve the patient's initial discomfort and to prevent deformity. Immobilization is most important in those patients with greater than 50% vertebral destruction for the first 3 months in order to prevent deformity.
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