Postoperative Spondylodiscitis. A Review of 24 Consecutive Patients

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Postoperative Spondylodiscitis. A Review of 24 Consecutive Patients

D. Adam, T. Papacocea, I. Hornea, R. Croitoru
Original article, no. 1, 2014
Background: Postoperative discitis is a rare complication ofspine surgery that creates a significant patient suffering andrequires long-term treatment. The aim of this study was tocompare the empirical antibiotic treatment with thetreatment according antibiotics to susceptibility of isolatesgerms in curing this complication.Material and method: In the period January 2002 - December2012, 4698 patients were operated for lumbar spine disorders:lumbar disc herniation, spinal canal stenosis. Of thesepatients, 47 (1%) were diagnosed with postoperative discitis. InDecember 2012 there were 24 cases of spondylodiscitis afterlumbar disc herniation operated by inter-lamar approach andforaminotomy. The A group of 13 patients received antistaphylococcalempirical antibiotic treatment. The B groupconsisting of 11 patients received antibiotic therapy after germisolation by open biopsy from discal intervertebral space (n=8)and from surgical wound secretion (n=3) and antibioticsusceptibility testing. Results: After 4 to 6 months of antibiotic treatment associatedwith immobilization in Boston corset the symptoms graduallyimproved in parallel with normalization of biologicalconstants, ESR, CRP. Five patients of Group A did notrespond to the given antibiotic treatment and required furtherdebridement and germ isolation.Conclusions: Spondylodiscitis is a complication of spinesurgery that is treated with antibiotics given for a long timeof 4-6 months. Germ isolation by needle biopsy or openbiopsy allows proper antibiotic treatment and faster healing.