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KMID : 1189320140080020177
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Asian Spine Journal
2014 Volume.8 No. 2 p.177 ~ p.182
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Surgical Management of Pyogenic Discitis of Lumbar Region
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Devkota Pramod
Krishnakumar R.
Renjith Kumar J.
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Abstract
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Study Design: Retrospective review of patients who had pyogenic discitis and were managed surgically.
Purpose: To analyze the bacteriology, pathology, management and outcome of pyogenic discitis of the lumbar region treated surgically.
Overview of Literature: Surgical management of pyogenic discitis is still an infrequently used modality of treatment.
Methods: A total of 42 patients comprised of 33 males and 9 females who had pyogenic discitis with a mean age of 51.61 years (range, 16-75 years) were included in this study. All the cases were confirmed as having pyogenic discitis by pus culture report and histopathological examination. The mean follow-up period was 41.9 months.
Results: Debridement and posterior lumbar interbody fusion with autologous iliac bone graft was done in all cases. Thirteen (30.95%) patients had other medical co-morbidities. Five cases had a previous operation of the spine, and three cases had a history of vertebral fracture. Three patients were operated for gynaecological problems, and four cases had a history of urological surgery. L4-5 level was the most frequent site of pyogenic discitis. The most common bacterium isolated was Staphylococcus aureus (S. aureus). Radiologically good fusion was seen in the majority of patients.
Conclusions: Pyogenic discitis should be suspected in people having pain and local tenderness in the spinal region with a rise in inflammatory parameters in blood. The most common bacterium was S. aureus, but there were still a greater number of patients infected with other types of bacteria. Therefore, antibiotics therapy should be started only after isolating the bacteria and making the culture sensitivity report.
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KEYWORD
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Pyogenic, Infection, Discitis, Antibiotics
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