The prevention of discitis during discography

Sharma, Shiv K.; Jones, Jacob C.; Zeballos, Pablo P.; Irwin, Stephen A.; Martin, Thomas W.

doi:10.1016/j.spinee.2009.06.001

Cited by 51 publications

(32 citation statements)

References 49 publications

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“…It is controversial whether discitis can be caused by an aseptic or infectious process and positive cultures may be obtained only in 42–73% of patients 23. Early diagnosis is crucial in the management of discitis because delayed treatment can lead to increased morbidity and mortality 45.…”

Section: Introductionmentioning

confidence: 99%

Postoperative discitis following single-level lumbar discectomy: Our experience of 17 cases

Basu¹,

Ghosh²,

Malik³

et al. 2012

IJOO

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Background:The established protocols of treatment of postoperative lumbar discitis have not been validated till date. We report a retrospective analysis of a series of patients with discitis following single level lumbar discectomy. We analyzed the outcome of conservative treatment of postoperative discitis with the objective to define when and what surgery was required when the conservative treatment failed.Materials and Methods:A total of 17 cases of postoperative discitis treated from 2002 to 2009 were followed up and evaluated clinically, radiologically and by laboratory investigations. All the patients were treated initially conservatively with rest and antibiotic therapy after diagnosis and those who did not respond to conservative treatment of at least 4 weeks were treated surgically. The cases were followed up with serial C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), X-ray, computed tomography (CT) scan and magnetic resonance imaging (MRI) for at least 1 year.Results:The mean followup was 40.38 months (range 12-86 months). Four cases failed to respond to conservative therapy and were treated surgically. In three of these four cases, open debridement, transpedicular fixation and posterolateral fusion was performed, and in the fourth case percutaneous transpedicular fixation was done. In the former group, one case was diagnosed to be tubercular, in another case Staphylococcus aureus was cultured where as the third case culture was sterile. All operated patients showed evidence of interbody fusion at 1 year followup.Conclusions:Early detection and aggressive treatment are paramount in managing postoperative discitis and the majority do well with conservative treatment. Surgical management in the form of transpedicular fixation and debridement, when required, gives excellent results.

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Section: Introductionmentioning

confidence: 99%

Postoperative discitis following single-level lumbar discectomy: Our experience of 17 cases

Basu¹,

Ghosh²,

Malik³

et al. 2012

IJOO

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“…No serious complications related to MB intervention were reported in the studies included in this review. However, some serious complications related to intervertebral disc injection were often reported in the literature, such as discitis (infection or inflammatory), disc herniation, and nerve or vascular injury . These complications should be taken into account in the procedure of intradiscal treatment.…”

Section: Discussionmentioning

confidence: 99%

Intradiscal Methylene Blue Injection for Discogenic Low Back Pain: A Meta‐Analysis

Ding

Liu

et al. 2018

Pain Practice

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“…The infection rate after discograms is 3.2% 22 . The typical infecting organisms are Staphylococcus aureus and Staphylococcus epidermidis ; other bacteria such as Escherichia coli have also been reported 23 .…”

Section: Treatment Of Cervical Postoperative Infectionmentioning

confidence: 99%

Progress in diagnosis and treatment of cervical postoperative infection

Che¹,

Li²,

Dong³

2011

Orthopaedic Surgery

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Postoperative infection is the commonest complication that causes failure of spinal surgery. Although the rate of infection after cervical surgery is lower than that after lumbar surgery, the absolute number of cases is increasing. In recent years, new techniques, such as serum amyloid A and fludeoxyglucose ( 18 F) positron emission tomography (18F-FDG PET), have emerged and gradually been employed in the diagnosis of postoperative infection, updating the ability to identify the presence of infection. Most patients with cervical postoperative infection require re-operation. There are three principles for such surgery: thorough debridement, adequate drainage and ensuring stability of the spine. Some severe cases even need emergency surgery. This article aims to discuss the controversial issues in diagnosis and treatment of cervical postoperative infection, as well as progress in related studies.Key words: Cervical vertebrae; Diagnosis; Infection; Surgical procedures, operative; Therapy Cervical postoperative infections occur after cervical spine surgery and other invasive operations. The incidence of cervical postoperative infection is lower than that of postoperative infection of other parts of the spine. However, in recent years with the increasing amount of cervical spine surgery and the launching of new treatment, the absolute number of cases has increased, which has drawn more clinical attention to this issue.It has been reported that the infection rate after anterior cervical surgery is in the 0-1% range 1,2 , and that posterior cervical surgery operation has a relatively higher risk of infection, about 1% with simple decompression and 4.5-9% with internal fixation 3,4 . Classificationo s4_140 152..157Cervical postoperative infection is classified as superficial or deep according to the level of infection 5 . Superficial infection is limited to the skin and subcutaneous layers, and does not involve the deep fascia. Deep infection refers to the infection in the deep fascia (nuchal ligament and platysma muscle) and involves muscle and its underlying compartments. Deep infection includes intervertebral disc inflammation (also called intervertebral space infection), vertebral osteomyelitis and epidural abscess. Cervical postoperative infection can also be classified according to its time of occurrence as early (within 3 weeks of the operation) and late-onset infection (more than 4 weeks after surgery).

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The prevention of discitis during discography

Cited by 51 publications

References 49 publications

Postoperative discitis following single-level lumbar discectomy: Our experience of 17 cases

Postoperative discitis following single-level lumbar discectomy: Our experience of 17 cases

Intradiscal Methylene Blue Injection for Discogenic Low Back Pain: A Meta‐Analysis

Progress in diagnosis and treatment of cervical postoperative infection

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