Keywords : local antibiotics
Use Of Local Vancomycin Antibiotics Injection Dose After End Of Endoscopic Percutaneous Discectomy To Reduce Or Prevent Post-Operative Discitis.
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 6, Pages 440-443
The rate of discitis after microscopic discectomy is 1% to 15% and by used of endoscopic discectomy the rate is 1-3% both with systemic prophylaxis antibiotics only. This event of complication can result of disability or death.
AimTo evaluate the infection rates associated with endoscopic lumber discectomy when using of local intradiscal injection and systemic antibiotics.
This retrospective study to analyzed patients under went endoscopic discectomy we gave all patients preoperative 2g of ceftriaxone iv and local intradiscal injection of antibiotics in the end of operation by a cocktail of (vancomycin 1g ,kenacote 40mg plus lidocaine 5ml of 2% ) all dissolved in 10 ml normal saline and injected inside the disc space. Discitis considered when a symptom reappears like back pain radicular pain, also elevation of ESR, CRP and leukocytosis. And this happened between 10 days to 1 month.
Results A total of 151 patients operated for lumber discectomy by using endoscopic procedure. 80 males ( 53% ) and 71 femeles (47% ). 121 (80.13%) of them posterolateral trans foraminal and 30 (19.87%) cases inter laminar approach. Age of ( 19 -61 ) years old average age is 32.5 years old , level of herniated disc L2-3 level 6 patients (3.97%). L 3-4 level 8 patients (5.3%) ,L4-5 level 107 patents (70.86%). L5-S1 level 30 patients (19.87%). All patient follow for 4 months and did blood test for ESR, CRP and WBC . one patient (0.66%) developed discitis and treated by systemic antibiotics,.
Conclusion Using of intravenous antibiotic (ceftriaxone ) 30 minutes preoperative and injection of cocktail of (vancomycin , kenacort and lidocaine) of 10 ml all and injected intradiscal reduce to prevent discitis.