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- Title
Post Operative Discitis Following Lumbar Discectomy.
- Authors
Triparthy, Sujit; Pattnaik, Ashish; Jain, Mantu
- Abstract
Introduction: Post operative discitis is a post procedural complication of spinal surgery. The diagnosis is mainly based on clinical findings supported by laboratory markers, and imaging modalities. Management includes biopsy and antibiotics and occasionally debridement and stabilization in nonresponsive cases Methods: 10 cases of postoperative Discitis were identified by clinical symptoms, laboratory investigations (ESR & CRP) radiological parameters (X-ray/CT-Scan/MRI) in AIIMS Bhubaneswar. All the patients were initially treated conservatively after diagnosis. Absolute bed rest in hospital for 3 weeks followed by gradual mobilization with a moulded LS Brace. Initial blood culture was sent. Empirical broad spectrum I.V Antibiotics were started and changed accordingly to C/S report for three weeks followed by oral antibiotics for another 3 weeks. Serial ESR/CRP and other radiological parameters were evaluated regularly. The patients who didn't respond to conservative treatment for three weeks were offered Surgery. The patients were reviewed at 1 month and 3 monthly thereafter. They were assessed with ESR, CRP and radiological parameters. Results: The ten cases had a Male: Female = 7:3, Mean age = 38.8years (Range: 24 -56years), mean follow up of 14.2 months (Range: 9 m to 20). Mean interval b/w Discectomy and establishment of diagnosis = 4.8 weeks (Range 1 to 10 weeks). Blood culture was positive in 4 cases (n = 3 staphylococcus, n = 1 for pseudomonas). 8 cases responded well to conservative treatment. 2 cases (20%) failed to respond and were treated surgically. one was sterile in intraoperative material and other had pseudomonas culture positive that required two debridement and fusion. Conclusion: Early detection and aggressive treatment is the cornerstone in management of Postoperative Discitis. Majority of them respond to conservative treatment. Surgical management is reserved for those not responding to IV antibiotics in whom isolation of germ is required or those with abscess.
- Publication
Global Spine Journal, 2018, Vol 8, p134S
- ISSN
2192-5682
- Publication type
Article
- DOI
10.1177/2192568218771030