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. 2023 Jul 10;107(1):51.
doi: 10.5334/jbsr.3127. eCollection 2023.

Usefulness of Percutaneous Drainage in Determining the Causative Microorganism in Patients with Spondylodiscitis: A Retrospective Cross-Sectional Study

Shoichi Ikenaga  1 , Daisuke Yunaiyama  1 , Mika Yasutomi  1 , Itaru Nakamura  2 , Mitsuru Okubo  1 , Toru Saguchi  1 , Motoki Nakai  1 , Kazuhiro Saito  1
Affiliations

Usefulness of Percutaneous Drainage in Determining the Causative Microorganism in Patients with Spondylodiscitis: A Retrospective Cross-Sectional Study

Shoichi Ikenaga et al. J Belg Soc Radiol. .

Abstract

Purpose: To determine the usefulness of CT-guided percutaneous drainage for the causative microorganism detection in patients with spondylodiscitis.

Materials and methods: Data of patients who underwent CT-guided percutaneous drainage for spondylodiscitis from January 2014 to April 2022 were extracted from the radiological database of our hospital and investigated. The administration rate of antibiotics prior to blood culture and CT-guided percutaneous drainage (CTPD) were analyzed. The detection rate of microorganisms via blood culture and CT-guided percutaneous drainage were compared using the Mann-Whitney's U test with the SPSS software.

Results: In this study, a total of 30 (20 male and 10 female) patients were analyzed. A total of 13 patients (43%) were administered antibiotics prior to blood culture. Of them, microorganisms were detected via blood culture in only one patient (7%). A total of 25 patients (83%) were administered antibiotics prior to CTPD. Of them, the causative microorganisms in 19 patients (76%) were detected. Overall, the causative microorganism could be detected in 24 out of 26 patients (92%) via CT-guided percutaneous drainage. There was a statistical significance in the detection rate of microorganisms between blood culture and CTPD (P = 0.004) in favor of CTPD.

Conclusion: CT-guided percutaneous drainage showed a high positive rate of microorganism detection in patients with spondylodiscitis regardless of antibiotic administration prior to the procedure. CT-guided percutaneous drainage can be a solution for the detection of the causative microorganism in spondylodiscitis patients who received antibiotics before obtaining any culture.

Keywords: drainage; infection; spondylodiscitis.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

CT-guided percutaneous drainage to spondylodiscitis
Figure 1
Summary of patient selection.
CT-guided percutaneous drainage to spondylodiscitis
Figure 2
Patients who underwent intradiscal and intrapsoas muscle drainage tube placement via CT-guided percutaneous insertion. (a) CT image showing the procedure for creating puncture to the disc space using a 18G Surflo needle guided by CT in the prone position under local anesthesia with procaine. (b) Fluoroscopy image demonstrating the injection of contrast-enhanced material through the outer sheath of the Surflo needle and then pulling it out. (c) Fluoroscopy image demonstrating a drainage tube being inserted into the discal space. A stiff-type guidewire (Amplatz ultrastiff guidewire, COOK medical Japan, Tokyo, Japan) was used. (d) A reconstructed CT image after the procedure showing that the drainage tube was located in the discal space.
See this image and copyright information in PMC

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