Postoperative spondilodiscitis

Gerometta, Antoine; Bittan, Fabian; Olaverri, Juan Carlos Rodríguez

doi:10.1007/s00264-011-1442-0

Cited by 43 publications

(35 citation statements)

References 56 publications

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“…Many patients were unable to stand, with the pain exacerbated by motions of the spine segments [6]. In a recent review article, the typical course of spondylodiscitis is the return of low back pain approximately six weeks later [16]. Similar to the previous studies, our patient also complained about pain being aggravated by motion and local tenderness around the infection site about 8 weeks after the spinal procedure.…”

Section: Discussionsupporting

confidence: 77%

Spondylodiscitis after Cervical Nucleoplasty without Any Abnormal Laboratory Findings

2013

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Infective spondylodiscitis is a rare complication that can occur after interventional spinal procedures, of which symptoms are usually back pain and fever. Early diagnosis of infective spondylodiscitis is critical to start antibiotics and to improve prognosis. Laboratory examinations including complet blood cell count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) are conventional tools for the early detection of infectious spondylitis. However, we experienced infective spondylodiscitis after cervical nucleoplasty which did not display any laboratory abnormalities, but was diagnosed through an MRI. A patient with cervical disc herniation received nucleoplasty at C5/6 and C6/7. One month later, the patient complained of aggravated pain. There were neither signs of chill nor fever, and the laboratory results appeared normal. However, the MRI findings were compatible with infectious spondylodiscitis at the nucleoplasty site. In conclusion, infectious spondylodiscitis can develop after cervical nucleoplasty without any laboratory abnormalities. Therefore, an MRI should be taken when there is a clinical suspicion for infection in order to not miss complications after interventional procedures, even if the laboratory findings are normal.

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Section: Discussionsupporting

confidence: 77%

Spondylodiscitis after Cervical Nucleoplasty without Any Abnormal Laboratory Findings

2013

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“…The patients with spondylodiscitis caused by tuberculosis could have negatively influenced the clinical outcome since tuberculosis has been suggested to have higher treatment failure rates, higher risk of deformity, and more often need surgical treatment [49,50]. On the other hand, childhood and postoperative spondylodiscitis are known to have a more favorable prognosis and could have positively influenced outcome results [2,51,52]. Final limitation of our current review is the quality of the available evidence, 80 % of the include studies have a very low level of evidence resulting in a weak level of recommendation.…”

Section: Strength and Limitationsmentioning

confidence: 99%

Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: a systematic literature review

et al. 2015

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Background Spondylodiscitis is a spinal infection affecting primarily the intervertebral disk and the adjacent vertebral bodies. Currently many aspects of the treatment of pyogenic spondylodiscitis are still a matter of debate. Purpose The aim of this study was to review the currently available literature systematically to determine the outcome of patients with pyogenic spondylodiscitis for conservative and surgical treatment strategies. Methods A systematic electronic search of MEDLINE, EMBASE, Cochrane Collaboration, and Web of Science regarding the treatment of pyogenic spondylodiscitis was performed. Included articles were assessed on risk of bias according the Cochrane Handbook for Systematic Reviews of Interventions, and the quality of evidence and strength of recommendation was evaluated according the GRADE approach. Results 25 studies were included. Five studies had a high or moderate quality of evidence. One RCT suggest that 6 weeks of antibiotic treatment of pyogenic spondylodiscitis results in a similar outcome when compared to longer treatment duration. However, microorganism-specific studies suggest that at least 8 weeks of treatment is required for S. aureus and 8 weeks of Daptomycin for MRSA. The articles that described the outcome of surgical treatment strategies show that a large variety of surgical techniques can successfully treat spondylodiscitis. No additional long-term beneficial effect of surgical treatment could be shown in the studies comparing surgical versus antibiotic only treatment. Conclusion There is a strong level of recommendation for 6 weeks of antibiotic treatment in pyogenic spondylodiscitis although this has only been shown by one recent RCT. If surgical treatment is indicated, it has been suggested by two prospective studies with strong level of recommendation that an isolated anterior approach could result in a better clinical outcome.

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“…As described, infections found at non-operated sites are rarely being reported. According to a previous study, through an analysis on the location of discitis occurring following operations of lumbar disc herniation, the infections occurred in 13 out of 111 patients at non-operated sites [ 5 ]. All of these 13 patients had infections localized to the lumbar region, and there were no cases of infections occurring in the thoracic or cervical regions.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Infectious Spondylitis After Surgical Treatments of Herniated Lumbar Intervertebral Disc

et al. 2013

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The postoperative infectious spondylitis has been reported to occur among every 1% to 12%. It is difficult to early diagnose in some cases. If the diagnosis is delayed, it can be a life-threatening condition. We report a 32-year-old male patient with postoperative infectious spondylitis. He had surgical treatments for traumatic intervertebral disc herniations in L3-4 and L4-5. Three weeks after surgery, he complained for fever and paraplegia. Cervicothoracic magnetic resonance imaging showed the collapsed T2 and T3 vertebral body with changes of bone marrow signal intensity. Moreover, it showed anterior and posterior epidural masses causing spinal cord compressions which suggested infectious spondylitis. After the use of antibiotics and surgical decompressions T2-T3, his general conditions were improved and muscle power of lower extremities began to be gradually restored. However, we could not identify the exact organisms that may be the cause of infectious spondylitis. It could be important that the infectious spondylitis, which is presented away from the primary operative level, should be observed in patients with fevers of unknown origin and paraplegia.

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Postoperative spondilodiscitis

Cited by 43 publications

References 56 publications

Spondylodiscitis after Cervical Nucleoplasty without Any Abnormal Laboratory Findings

Spondylodiscitis after Cervical Nucleoplasty without Any Abnormal Laboratory Findings

Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: a systematic literature review

Thoracic Infectious Spondylitis After Surgical Treatments of Herniated Lumbar Intervertebral Disc

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