Asian Spine J.  2014 Apr;8(2):177-182. 10.4184/asj.2014.8.2.177.

Surgical Management of Pyogenic Discitis of Lumbar Region

• Devkota P
• Krishnakumar R
• Renjith Kumar J

• KMID: 2270372
• DOI: http://doi.org/10.4184/asj.2014.8.2.177

Abstract

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.

Keyword

Pyogenic; Infection; Discitis; Antibiotics

MeSH Terms

Anti-Bacterial Agents
Bacteria
Bacteriology
Debridement
Discitis*
Female
Follow-Up Studies
Humans
Lumbosacral Region*
Male
Pathology
Retrospective Studies
Spine
Staphylococcus aureus
Suppuration
Transplants
Anti-Bacterial Agents