| ORIGINAL ARTICLE |
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| Year : 2017 | Volume
: 8
| Issue : 1 | Page : 39-43 |
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The role of minimally invasive spine surgery in the management of pyogenic spinal discitis
Mazda K Turel, Mena Kerolus, Harel Deutsch
Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA
Correspondence Address:
Mazda K Turel
Department of Neurosurgery, Rush University Medical Center, 1725 W, Harrison Street, Suite 855, Chicago, IL
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0974-8237.199873
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Background: Diagnostic yields for spondylodiscitis from CT guided biopsy is low. In the recent years, minimally invasive surgery (MIS) has shown to have a low morbidity and faster recovery. For spinal infections, MIS surgery may offer an opportunity for early pain control while obtaining a higher diagnostic yield than CT-guided biopsies. The aim of this study was to review our patients who underwent MIS surgery for spinal infection and report outcomes.
Methods: A retrospective review of seven patients who underwent MIS decompression and/or discectomy in the setting of discitis, osteomyelitis, spondylodiscitis, and/or an epidural abscess was identified. Patient data including symptoms, visual analog score (VAS), surgical approach, antibiotic regimen, and postoperative outcomes were obtained.
Results: Of the 7 patients, 5 patients had lumbar infections and two had thoracic infections. All seven patients improved in VAS immediately after surgery and at discharge. The average VAS improved by 4.4 ± 1.9 points. An organism was obtained in 6 of the 7 (85%) patients by the operative cultures. All patients made an excellent clinical recovery without the need for further spine surgery. All patients who received postoperative imaging on follow-up showed complete resolution or dramatically improved magnetic resonance imaging changes. The follow-up ranged from 2 to 9 months.
Conclusions: MIS surgery provides an opportunity for early pain relief in patients with discitis, osteomyelitis, spondylodiscitis, and/or epidural abscess by directly addressing the primary cause of pain. MIS surgery for discitis provides a higher diagnostic yield to direct antibiotic treatment. MIS surgery results in good long-term recovery. |
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