Abstract Background: Spondylodiscitis poses significant challeng-es in spinal pathology management. This research evaluted outcomes between conservative treatment and transpedicular screw fixation in spondylodiscitis patients. Patients and Methods: This retrospective study included 32 participants with lumbar or thoracolumbar spondylodisci-tis, equally divided into conservative treatment (Group A) and transpedicular screw fixation (Group B) groups. The Oswestry Disability Index (ODI) was used to measure functional capa-bility, while the visual analog scale (VAS) was used to assess pain levels. Follow-ups were conducted at 1, 3, and 6 months post-intervention. The primary outcome was recurrence rate, while secondary outcomes included changes in pain and func-tion, complications, and infection-related death. Results: VAS and ODI scores were significantly lower in Group B at 3 and 6 months (p<0.05). The recurrence rate was significantly lower in Group B (6.25%) compared to Group A (43.75%) (p=0.037). Infection rates were not significantly dif-ferent between groups. No cases of hematoma or bleeding oc-curred in either group. Conclusions: Transpedicular screw fixation demonstrated superior outcomes in pain relief, functional improvement, and reduced recurrence rates compared to conservative manage-ment in spondylodiscitis patients. These findings suggest that surgical intervention may offer better long-term efficacy in managing spondylodiscitis.