Analysis of results of open and percutaneous disc biopsy in the diagnosis of spondylodiscitis.

Autor: Navarro-Navarro R; Unidad de Raquis, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España. Electronic address: Ricnavarro2@yahoo.es., Suárez-Cabañas AH; Servicio de Cirugía Ortopédica y Traumatologia, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España., Fernández-Varela T; Unidad de Raquis, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España., Lorenzo-Rivero JA; Unidad de Raquis, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España., Montesdeoca-Ara A; Unidad de Raquis, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de cirugia ortopedica y traumatologia [Rev Esp Cir Ortop Traumatol] 2022 May-Jun; Vol. 66 (3), pp. 189-199. Date of Electronic Publication: 2021 Nov 23.
DOI: 10.1016/j.recot.2021.09.005
Abstrakt: Introduction: Spinal disc biopsy is a necessary tool in diagnosing and treating spondylodiscitis. Its profitability varies according to the technique, concomitant antibiotics therapy or causative germ. We studied the results of this procedure in our institution.
Materials and Methods: Retrospective analysis of all cases requiring disc biopsy due to possible spondylodiscitis over a 5year period, both percutaneous (26 cases) and open (13 cases). We collected filiation and clinical data, comorbidity, concomitant antibiotic therapy, imaging tests, biopsy type, cultures results and clinical evolution.
Results: 39 patients; 66.7% male, 66.9years of average age. 74% has known risk factors. The main symptom was pain (89.7%). Fever occurred in 5%. MRI performed in 87%. Lumbar involvement in 76.9%. 9 patients (23%) received antibiotic treatment simultaneously with biopsy. In these cases biopsy always yielded a negative result, but positive in patients without antibiotics at the time of the biopsy (53.3%), with statistical significance. Most frequent isolated microorganisms were gram-negative bacilli (31.2%) and gram-positive cocci (31.2%). We found 2 deaths during admission for sepsis (within the first month after diagnosis). Of the rest of patients, 5 died late during the follow-up: 3 due to new infections and 2 due to subsequent complications of previous pathologies. The remaining patients with final diagnosis of spondylodiscitis evolved satisfactorily with antibiotic therapy.
Conclusions: Spondylodiscitis is potentially serious and requires an adequate diagnosis, with disc biopsy being a necessary procedure on occasions. Patients poor clinical condition can make it impossible to withdraw antibiotics, which drastically reduces the performance of the biopsy.
(Copyright © 2021 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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