Surgical Management of Pyogenic Discitis of Lumbar Region.
- Author:
Pramod DEVKOTA
1
;
R KRISHNAKUMAR
;
J RENJITH KUMAR
Author Information
- Publication Type:Original Article
- Keywords: Pyogenic; Infection; Discitis; Antibiotics
- MeSH: Anti-Bacterial Agents; Bacteria; Bacteriology; Debridement; Discitis*; Female; Follow-Up Studies; Humans; Lumbosacral Region*; Male; Pathology; Retrospective Studies; Spine; Staphylococcus aureus; Suppuration; Transplants
- From:Asian Spine Journal 2014;8(2):177-182
- CountryRepublic of Korea
- Language:English
- Abstract: STUDY DESIGN: Retrospective review of patients who had pyogenic discitis and were managed surgically. PURPOSE: To analyze the bacteriology, pathology, management and outcome of pyogenic discitis of the lumbar region treated surgically. OVERVIEW OF LITERATURE: Surgical management of pyogenic discitis is still an infrequently used modality of treatment. METHODS: A total of 42 patients comprised of 33 males and 9 females who had pyogenic discitis with a mean age of 51.61 years (range, 16-75 years) were included in this study. All the cases were confirmed as having pyogenic discitis by pus culture report and histopathological examination. The mean follow-up period was 41.9 months. RESULTS: Debridement and posterior lumbar interbody fusion with autologous iliac bone graft was done in all cases. Thirteen (30.95%) patients had other medical co-morbidities. Five cases had a previous operation of the spine, and three cases had a history of vertebral fracture. Three patients were operated for gynaecological problems, and four cases had a history of urological surgery. L4-5 level was the most frequent site of pyogenic discitis. The most common bacterium isolated was Staphylococcus aureus (S. aureus). Radiologically good fusion was seen in the majority of patients. CONCLUSIONS: Pyogenic discitis should be suspected in people having pain and local tenderness in the spinal region with a rise in inflammatory parameters in blood. The most common bacterium was S. aureus, but there were still a greater number of patients infected with other types of bacteria. Therefore, antibiotics therapy should be started only after isolating the bacteria and making the culture sensitivity report.
