Surgical Strategies for Spondylodiscitis due to Lumbar Disc Surgery
AIM: Despite different surgical treatment protocols at different centers for spondylodiscitis due to lumbar surgery, there is no
consensus on its surgical indications. In this study, we aimed to clarify the steps to be followed in the management and treatment
of postoperative spondylodiscitis.
MATERIAL and METHODS: The data of 20 cases with postoperative spondylodiscitis were evaluated. C-reactive protein (CRP)
was used for diagnosis and follow-up. According to culture results of the infected material obtained from the operated cases,
appropriate antibiotic treatment was initiated. In non-operated cases, parenteral empirical antibiotic treatment was implemented.
Surgical treatment was planned for cases with clinical and radiological instability, abscess on imaging and those who were nonrespondent
to empirical antibiotic treatment. For the cases that clinically recovered and had normal CRP levels, oral antibiotic
treatment was continued after parenteral antibiotic treatment.
RESULTS: Of the cases; 13 were male (65%) and 7 were femals (35%). The mean age was 56.3 years (32-74). The most prevalent
complaints in referral were waist and leg pain. Except one, all cases had increased CRP levels. All patients had spondylodiscitis
on magnetic resonance imaging. Seven had radiological and clinical instability and 3 had epidural abscess. The most commonly
growing microorganism in culture was Staphylococcus aureus. Surgical treatment was applied to seven cases and medical treatment
to 13 cases.
CONCLUSION: In cases with waist pain in the postoperative period, the first potential diagnosis to be considered is spondylodiscitis.
Surgical treatment should be implemented for cases resistant to empirical antibiotic treatment, with abscess on imaging, or with