Online ISSN: 2515-8260

Keywords : Spondylodiscitis


Management of Patients with Spondylodiscitis: An Overview

Sufwan Elbasher Alsadiq Algrmi; Mahmoud Mustafa Mohamed Taha ,Ibrahim Metwaly Abdel Fattah,Essam Mohamed Elsayed Youssef

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3023-3034

Background:Spinal infections can be described etiologically as pyogenic, granulomatous (tuberculous, brucellar, fungal) and parasitic spondylodiscitis, a term encompassing vertebral osteomyelitis, spondylitis and discitis, which are considered different manifestations of the same pathological process; epidural abscess, which can be primary or secondary to spondylodiscitis and facet joint arthropathy.When infection affects the intervertebral disc, the term to describe this condition is usually spondylodiscitis. If invades the endplates or the vertebral body, the infection is more correctly designated for vertebral osteomyelitis or spondylitis. However, at the time of diagnosis in many cases, the infection has already compromised these two structures; therefore, both terms are frequently used.Conservative treatment is the standard of care for patients with spondylodiscitis, using multidisciplinary approaches involving microbiologists, infectious disease consultants, anaesthetists, intensivists and geriatricians, with public health physicians for contact tracing. The morbidity and mortality of patients with spondylodiscitis treated conservatively has fallen from 56% to 25% over the last 15 years.However, careful selection of patients who need surgical treatment is necessary. Surgical treatment is absolutely indicated in patients with spinal cord or cauda equina compression with progressive neurological deficits. Relative surgical indications include spinal instability due to extensive bone destruction, significant deformity or conservative treatment failure

EMERGENCY OSTEOPERFORATION IN POST-OPERATIVE SPONDYLOGIS

Pardaev Saidkasim Narkulovich; Narkulov Maksudzhon Saidkasimovich; Meliboev Salim Tashtanovich; Khasanov Aziz Batirovich

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 2304-2310

Infectious spondylitis accounts for 4 - 8% among suppurative diseases of the musculoskeletal system, and its frequency is estimated at 1.0 - 2.5 cases per 100,000 population. A special form of spondylodiscitis - acute post-manipulation spondylodiscitis - is observed in one of 40-50 patients who underwent discectomy from the posterior approach for a herniated disc, which, given that this operation is the most frequent in neurosurgery, allows one to assess the total volume of the problem.

Use Of Local Vancomycin Antibiotics Injection Dose After End Of Endoscopic Percutaneous Discectomy To Reduce Or Prevent Post-Operative Discitis.

Ammar Najim Abood

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.