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Pyogenic discitis a commonly missed diagnosis after lumbar surgery
Despite diagnosis challenges, pyogenic discitis should be suspected in patients with localized pain, tenderness and systemic illness following lumbar-region surgery, according to researchers.
A retrospective review of 42 patients with pyogenic discitis (33 male, 9 female) analyzed the bacteriology, pathology, management and outcome of surgically treated cases. Patients’ mean age was 51.6. Mean follow-up was 41.9 months.
Five patients had undergone previous spine operation, and three had a history of vertebral
fracture. Three other patients had undergone operations for gynecological problems, and four patients had history of urological surgery.
Local pain at the affected site was the most common sign of infection in 37 patients (88%). Staphylococcus aureus was the most commonly isolated bacterium, found in 19 patients (45.24%), followed by Escherichia coli, which was isolated in 7 patients (16.65%). The L4-L5 segment was the most common area of infection (45.24%), followed by the L3-L4 segment (19.05%), according to the researchers.
Disclosure: The authors have no relevant financial disclosures.
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Devotka P. Asian Spine J. 2014. doi:10.4184/asj.2014.8.2.177.