Objectives: This study aims to evaluate the outcomes of different management strategies in PSIs, with a focus on infections caused by S. epidermidis and TB organisms. Specific emphasis is placed on the role of antimicrobial and anti-TB drug therapies, as well as revision surgical procedures.

Materials and Methods: A retrospective analysis was conducted on 31 patients diagnosed with PSI at Bangladesh medical university between 2015 and 2024. Diagnosis was based on clinical presentation, laboratory markers, imaging studies, and microbiological confirmation. 14 patients received targeted antimicrobial therapy for pyogenic infections 5 patients received anti-TB therapy for tubercular infections. Revision surgical management, 7 patients underwent debridement only, 3 patients underwent debridement with fusion and 2 patients underwent debridement with fixation. Assessment was done at 1st, 2nd, and 3rd monthly by VAS, Odom Criteria, Nurick’s grading.

Result: The mean age of the patients was 57.13 ± 6.14 years (range 40–65), with the majority (60%) aged between 51–60 years. Males comprised 73.3% of the study population. All patients had varying degrees of post operative spinal infection. Postoperatively, the mean VAS score significantly improved from 6.27 ± 1.75 to 0.73 ± 0.59 at 12 months (p < 0.001). According to the Modified Odom Criteria, 33.3% of patients had excellent outcomes, 60.0% had good outcomes, and 6.7% had fair outcomes. Functional status measured by Nurick’s grading improved significantly, with 93.3% of patients in Grade III preoperatively and 87% improving to either Grade 0 or I by 3rd months (p < 0.001).

Conclusion: Effective management of PSIs depends on early diagnosis, appropriate antimicrobial or anti-TB therapy, and timely surgical intervention. S. epidermidis infections respond well to targeted antimicrobial therapy and debridement, whereas TB infections require prolonged anti-TB regimens and often more extensive surgical stabilization.