Clinical Study of Discitis in Adult
10.4055/jkoa.1986.21.2.211
- Author:
Byeong Moon PARK
;
Nam Hyun KIM
;
Sung Jae KIM
;
Jun Dong CHANG
- Publication Type:Original Article
- Keywords:
Intervertebral disc(s);
infection;
in adult
- MeSH:
Abscess;
Adult;
Anti-Bacterial Agents;
Back Pain;
Braces;
Cell Count;
Child;
Clinical Study;
Curettage;
Diagnosis;
Discitis;
Diskectomy;
Humans;
Immobilization;
Intervertebral Disc;
Lifting;
Orthopedics;
Pseudomonas aeruginosa;
Recurrence;
Spine;
Staphylococcus;
Transplants;
Urinary Tract Infections
- From:The Journal of the Korean Orthopaedic Association
1986;21(2):211-222
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A primary infection of the intervertebral disc in adult is an uncommon entity. Usually these patients are not actually ill and their symptoms have been present for some months. Pyogenic infection of the intervertebral disc in children was well documented by a number of authors,but this condition was less well recognized in the adult. We analysed 12 cases of discitis in adults which were treated at the Department of Orthopedic Surgery of Severance Hospital for 10 years from January 1975 to March 1984 by curettage and autogenous iliac bone graft through anterior approach. The results obtained from this study were as follows: 1. The average duration of symptoms before diagnosis was 9.6 months. 2. The lumbar spine was involved in 83% and next in thoracic spine. 3. The most prominent symptoms and signs are backache and local tenderness at the site of the lesion. 4. Ten patients had the preceding disease or definile past history of previous back surgery, myelogram, abscess, urinary tract infection, heavy lifting and back trauma. 5. The white cell count was of little value in the initial investigation, but the E.S.R. was raised in 67%. 6. Positive cultures from the intervertebral disc were obtained in 8 cases(67%). The causative organisms were 5 Staphylococcus, 2 E-coli, and 1 Pseudomonas aeruginosa. 7. The most common radiological finding on admission was narrowing of the intervertebral disc space, and the tomogram showed the most reliable finding for the preoperative diagnosis. 8. In the treatment, focal curettage or diskectomy and anterior fusion with autogenous iliac bone graft was done in all cases. Antibiotics were administrated for 4 to 10 weeks (average 5.5 weeks) after operation and the cast or brace was applied for immobilization. 9. Over-all clinical result were as follows; eight patients (67%) excellent, 3 patients good, 1 patient fair, and no recurrence.
