Abstract
Purpose
The focus of this study was to analyse the patient with disc space infection and the need for re-exploration.
Method
Thirty-five patients were analysed within the period from April 1992 and May 2011. The diagnosis was confirmed by the cardinal clinical features, raised erythrocyte sedimentation rate [ESR], raised C-reactive protein and MRI findings. All received 500-mg intravenous amikacin and one gram ceftriaxone at the time of anaesthetic induction and six hours after surgery.
Results
Age range was between 25–62 years. The appearance of symptoms was between four days and three weeks. Nine patients had silent chronic urinary tract infection. Twenty-nine patients had re-exploration while the others did well on conservative treatment. Neurological deficit was not recorded. All recovered well within six to nine months.
Conclusion
Re-exploration is recommended if no response is achieved after four day’s conservative treatment for or if the patient’s condition is critical.
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References
Ford LT, Key JA (1955) Postoperative infection of intervertebral disc space. South Med J 48(12):1295–1303
Piotrowaski WP, Krombholz MA, Muhl B (1994) Spondylodiscitis after lumbar disc surgery. Neurosurg Rev 17:189–193
Osenbach RK, Hitchon PW, Menezes AH (1990) Diagnosis and management of pyogenic vertebral osteomyelitis in adult. Surg Neurol 33:266–275
Williams et al. (1999) Fungal spinal osteomyelitis in immunocompromised patients. Am J Neuroradiol 20:381–385
Beguiritain JL, Depablos J, Lombark R, Gomez A (1986) Discitis due to clostridium perfringens. Spine 11(2):170–172
Stephanian E, Coffey RJ, Segal R (1989) Intervertebral disc space infection and osteomyelitis due to Hemophilus species. Spinal disorders 2(2):114–119
Lang EW, Pitts LH (1996) Intervertebral disc space infection caused by Aspergillus fumigatus. Eur Spine J 5(3):207–209
El-Gindi S, Aref S, Salama M et al. (1976) Infection of intervertebral discs after operation. J Bone Joint Surg Br 58:114–116
Dall BE, Rowe DE, Odette WG, Battes DH (1987) Postoperative discitis: diagnosis and management. Clin Orthop Relat Res 224:138–146
Mumtaz A, Muhammed Y (2010) Lumbar discitis, prevalence and management after lumbar disc surgery. Professional Medicine Journal 17(4):628–632
Puranen J, Makela J, Lahde S (1984) Postoperative intervertebral discitis. Acta Orthop Scand 55:461–465
Dauch WA (1986) Infection of the intervertebral space following conventional and microsurgical operation. Acta-Neurochir (Wien) 82:43–49
Dietze DB, Fessler RG, Jacon RP (1997) Primary reconstruction for spinal infection. J Neurosurg 86:981–989
Manuel E et al (1999) Postoperative spondylodiskitis: etiology, clinical findings, prognosis, and comparison with nonoperative pyogenic spondylodiskitis. Clinical Infectious Disease 29:339–345
Sapico FL, Montgomerie JZ (1979) Pyogenic vertebral osteomyelitis, report of nine cases and review of the literature. Rev Infect Dis 1:754–756
Bircher MD, Tasker T, Crawshaw C, Mulholland RC (1988) Discitis following lumbar surgery. Spine 13:98–102
Rawling CE, Wilkins RH, Gallis HA, Goldner JR, Francis R. (1983). Postoperative intervertebral disc space infection. Neurosurgery 13:371–375
Rebecca W, Ramzi R, Robert F, Robert M (2006) Preventing and treating discitis: Cephazolin penetration in ovine lumbar intervertebral disc. Eur Spine J 15(9):1397–1403
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Hamdan, T.A. Postoperative disc space infection after discectomy: A report on thirty-five patients. International Orthopaedics (SICOT) 36, 445–450 (2012). https://doi.org/10.1007/s00264-011-1430-4
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DOI: https://doi.org/10.1007/s00264-011-1430-4