Full-Endoscopic Discectomy and Debridement for Iatrogenic Spondylodiscitis After a Lumbar Peritoneal Shunt
10.21182/jmisst.2023.01137
- Author:
Chien-Li HUANG
1
;
Jiun-Yi HUANG
;
Chien-Min CHEN
;
Jae Hwan LEE
Author Information
1. Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Chuanghua City, Taiwan
- Publication Type:Case Report
- From:
Journal of Minimally Invasive Spine Surgery and Technique
2024;9(1):31-36
- CountryRepublic of Korea
- Language:English
-
Abstract:
Lumbar peritoneal shunt (LPS) is the standard treatment for nonobstructive hydrocephalus. Shunt infection, overdrainage, bleeding, and cerebrospinal fluid leaks have been reported as LPS complications. We present a 70-year-old man who developed iatrogenic spondylodiscitis 2 weeks after LPS placement, experiencing severe back pain and neurological deficits. Despite the empiric antibiotics, his symptoms persisted. The patient underwent fully endoscopic debridement and drainage (FEDD) to address the infection without LPS removal. After the procedure, the patient experienced a significant reduction in pain. Even though pathogen cultures were negative, the empiric antibiotic treatment continued for 6 full weeks. The patient was able to ambulate with a thoracolumbar orthosis due to the lumbar kyphotic deformity. FEDD, in conjunction with effective antibiotics, offers rapid pain relief and functional improvement in iatrogenic spondylodiscitis, even with LPS placement. However, FEDD may not correct spinal deformities and is unsuitable for advanced spinal disease or instability. Early detection of spondylodiscitis is crucial for improved outcomes.
