We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Post-Discectomy Infection: A Critical Review and Suggestion of a Management Algorithm.
- Authors
Chaniotakis, Constantinos; Koutserimpas, Christos; Tsantes, Andreas G.; Papadopoulos, Dimitrios V.; Tsiridis, Christothea-Alexandra; Karantanas, Apostolos; Alpantaki, Kalliopi; Hadjipavlou, Alexander
- Abstract
Postoperative discitis (POD) accounts for 20% to 30% of all cases of pyogenic spondylodiscitis, while POD may be mis-or-under-diagnosed, due to the vague related symptomatology and the non-specific imaging findings. Most studies report infection rate of less than 1%, which increases with the addition of non-instrumented fusion to 2.4% to 6.2%. It remains controversial whether POD is caused by an aseptic or infectious process. Positive cultures are presented only in 42–73% of patients with Staphylococcus species being the most common invading organisms, while Staphylococcus aureus is isolated in almost 50% of cases. The onset of POD symptoms usually occurs at 2–4 weeks after an apparently uneventful operation. Back pain and muscle spasms are usually refractory to bed rest and analgesics. Magnetic Resonance Imaging (MRI) is the most sensitive and specific imaging diagnostic technique. Antimicrobial therapy depends on the results of tissue cultures, and along with bracing represents the mainstay of management. Surgical intervention is necessary in patients failing conservative treatment. For the majority of cases, extensive surgical debridement, antibiotic therapy, and orthosis immobilization are effective in eliminating the infection. According to this, we recommend an Algorithmic approach for the management of POD. Postoperative infections after spinal surgery pose a certain clinical challenge, and in most cases can be treated conservatively. Nevertheless, disability may be persistent, and surgery could be necessary. The purpose of this concise review is to describe the manifestation of post-discectomy infection, its pathogenesis and particularly a rational approach for its management.
- Subjects
SPASMS; DISCECTOMY; MAGNETIC resonance imaging; ASEPTIC packaging; BACK muscles; BED rest; SPINAL surgery; SPONDYLODISCITIS
- Publication
Journal of Clinical Medicine, 2024, Vol 13, Issue 5, p1478
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm13051478