Despite modern diagnostic investigations, pyogenic infections of the spine are often detected late and are therefore associated with a high lethality. To ensure efficient and adequate therapy, it is necessary to identify and treat the focus of the inflammation. Urogenic spinal infections are often underestimated in their frequency of occurrence and severity of symptoms. From 1994 to 2006, 209 patients suffering a spinal infection were treated in the Department of Orthopedic Surgery. In 13 of them (6.2%), a urogenital inflammation caused the spondylodiscitis. In the context of a retrospective clinical trial, we investigated the risk factors, clinical aspects, and therapeutic consequences of patients with urogenic spinal infections and those with another genesis. The two data sets were compared, and therapeutic differences were extracted.