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Endoscopic discectomy may mitigate need for preoperative antibiotics
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LYON, France — Bacteria may not be the cause of Modic changes in the spine, according to results of a 2-year prospective study presented here at the EuroSpine Annual Meeting.
Desmond Taofiq Sanusi and a colleague sought to test disc samples obtained endoscopically to determine whether they showed the presence of Propionibacterium, and could possibly be the cause of Modic changes. They conducted the study when Sanusi was in the neurosurgery department at King’s College Hospital in London.
Twenty-four patients with confirmed degenerative disc disease aged 25 years to 66 years old were given the antibiotic cerfuoxime minutes before endoscopic disc sample acquisition under aseptic conditions. Nineteen similar patients were not given the antibiotic before their procedures.
The researchers sent about 10 disc fragments per patient in both groups taken from levels L5/S1, L4-5 and a few other levels to the lab for microbiological testing and culturing, which was done at 37º for 7 days. Microbiology results showed that some of the cultured samples grew organisms.
“In 43 patients, 430 disc samples, we have not been able to identify any Propionibacterium. And our conclusion: In the previous study [of Albert] just about 40% of patients had Propionibacterium. We did not have any Propionibacterium,” Sanusi said.
This study was the first to acquire disc material via a very minimal method and it showed there was likely not a need to use antibiotics in these types of cases, he said. – by Susan M. Rapp
References:
Albert HB. Eur Spine J. 2013;doi:10.1007/s00586-013-2675-y.
Sanusi DR. Paper #48. Presented at: EuroSpine Annual Meeting; Oct. 1-3, 2014; Lyon, France.