Cost-Based Evaluation of Spondylodiscitis Management in Türkiye: From Diagnosis to Treatment Completion

Abstract

Objective: Spondylodiscitis, though rare, poses considerable diagnostic and therapeutic challenges, often requiring prolonged hospitalization, extensive imaging, long-term antibiotic therapy, and sometimes surgical intervention. In resource-limited healthcare systems, its economic burden remains poorly characterized. This study aimed to provide a cost-based evaluation of spondylodiscitis management in Türkiye, assessing clinical, radiological, and laboratory parameters from diagnosis to treatment completion. Methods: A retrospective single-center analysis was conducted on patients diagnosed and treated for spondylodiscitis between January 2012 and December 2023. After applying strict inclusion and exclusion criteria to avoid confounding, 32 patients were analyzed. Costs were calculated using reimbursement rates from the Social Security Institution of Türkiye and converted to Euros. Subgroup comparisons were made between primary versus secondary cases, culture-positive versus culture-negative cases, and patients with versus without comorbidities. Nonparametric analyses were performed due to non-normal cost distributions. Results: The cohort included 18 females and 14 males with a mean age of 57.5 years. Pathogens were identified in 60.6% of cases, with Staphylococcus aureus being most common. Nineteen patients (54.3%) required surgical intervention. The mean antibiotic duration was 10.8 weeks. The total treatment cost was €50,128.77, averaging €1,566.52 per patient. Secondary spondylodiscitis, absence of pathogen identification, and lack of comorbidities tended to increase costs, though no subgroup difference reached statistical significance. Surgical interventions represented the largest cost component. Conclusions: The mean per-patient cost of spondylodiscitis management in Türkiye was markedly lower than figures reported in high-income countries. Early diagnosis, pathogen identification, and standardized surgical decision-making may reduce unnecessary expenditures while ensuring effective clinical outcomes. © 2025 The Authors