• Chia-Wei Chang, Tsung-Ting Tsai, Chi-Chien Niu, Tsai-Sheng Fu, Po-Liang Lai, Lih-Huei Chen, and Wen-Jer Chen.
• Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan; Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan.
• World Neurosurg. 2019 Jan 1; 121: e755-e760.

BackgroundTraditionally, nonoperative management with long-term antibiotics and bed rest has been recommended as first-line treatment for most patients with postoperative discitis. A recent trend in treatment under a limited range of indications has been to perform surgical débridement followed by long-term administration of antibiotics. This descriptive study investigated whether transforaminal lumbar interbody débridement and fusion (TLIDF) combined with intravenous antibiotics is appropriate to manage postdiscectomy discitis.MethodsThis study retrospectively analyzed demographic data, laboratory data, and radiography and magnetic resonance imaging of 10 patients with postoperative discitis who underwent surgical TLIDF followed by antibiotic treatment. Preoperative and postoperative spine sagittal alignment, visual analog scale scores, and Kirkaldy-Willis criteria for functional outcomes were evaluated.ResultsAn infection clearance rate of 100% was ultimately achieved for the patients who underwent TLIDF with short posterior instrumentation. TLIDF yielded better outcomes than traditional conservative treatment in terms of spine alignment correction, functional outcomes, and quality of life.ConclusionsBased on previously reported data and the findings of this study, we suggest that surgical intervention should be used in certain cases, as it can achieve better outcomes than conservative treatment. We recommend a novel single posterior approach with TLIDF and posterior pedicle screw instrumentation for management of postdiscectomy discitis.Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

26 keywords...

hide…