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. 2017 Jan-Mar;8(1):39-43.
doi: 10.4103/0974-8237.199873.

The role of minimally invasive spine surgery in the management of pyogenic spinal discitis

Mazda K Turel  1 , Mena Kerolus  1 , Harel Deutsch  1
Affiliations

The role of minimally invasive spine surgery in the management of pyogenic spinal discitis

Mazda K Turel et al. J Craniovertebr Junction Spine. 2017 Jan-Mar.

Abstract

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.

Keywords: Discitis; minimally invasive spine surgery; osteomyelitis; spinal infection; spondylodiscitis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Sagittal magnetic resonance imaging showing T7–T8 spondylodiscitis with an epidural abscess
Figure 2
Figure 2
(a) Operative room setup for minimally invasive surgery and (b) transpedicular discectomy using tubular retractors and removal of pus (*) from the disc space
Figure 3
Figure 3
Postoperative computed tomography scan showing the minimally invasive approach and trajectory of surgery (arrows) with excellent outcome
See this image and copyright information in PMC

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