抄録
The authors report a retrospective study of clinical results of 12 patients (13 disks) who were suspected of having spontaneous (non-postoperative) pyogenic spondylodiskitis, and underwent percutaneous diskectomy and drainage (PD).
The patients were treated between 2001 and 2004. The 12 patients were 8 men and 4 women, whose ages ranged from 42-82 years. Three of 13 disks were at the level of thoracic spine, and 10 disks were at the lumbar spine. Five of 13 disks were treated under CT guidance, and 8 disks were treated under image intensifier guidance. All of the patients complained of local pain, but none of them had neurological deficit.
Speciments PD, all cases had microbiologic analysis, and the choice of antibiotic treatment depended on the organisms isolated from the disk. The follow-up of all patients included clinical examinations, blood testing for inflammatory signs, as well as neurological examinations, and MRI.
The drainage duration was from 8-41 days, with an average duration of 22.8 days. Specific organisms were isolated in 8 of the 13 disks. (61.5%) Staphylococcus aureus were identified in 7 of the 13 disks, of which 2 cases were MRSA. All patients had clinical improvement during the follow-up period.
The duration of inflammation was from 8-88 days, with an average duration of 24.4 days. In the cases with MRSA, the duration of inflammation was from 54-88 days, with an average duration of 71.0 days. 2 cases had recurrence, but improved using antibiotics. No neurological complications were found during the procedure.
During the early stage of spondylodiskitis, PD is an efficient and safe procedure. But when MRSA is isolated from the disk and granulation tissue, irrigation or further decompression and reconstructive surgery must be considered.
