Discitis after lumbar disc surgery. Features of "aseptic" and "septic" forms.
Two major types of postoperative discitis have been previously described: septic discitis and "avascular" or "chemical" discitis. Percutaneous discal biopsy is an important way of distinguishing these entities. In a retrospective study of 25 cases of postoperative discitis, three groups have been analyzed with bacteriologic and histologic tests: a group of nine patients (group A) with positive discal bacteriologic cultures; a group of eight patients (group B) with typical septic histologic tests but negative bacteriologic discal procedures; and a group of eight patients (group C) in whom the histologic picture was reminiscent of a mechanical process. No group was unique in any clinical and radiologic parameter. Group A and group B were quite similar in biological features, but group C had erythrocyte sedimentation rate and C-reactive protein serum levels significantly lower than groups A and B (P less than 0.01). After 4 weeks, these differences were still present. This study confirms that there are two main features of postoperative discitis that can be recognized by histologic and biological tests, allowing for different treatments.
Fouquet
B
B
Unit of Physical Medecine, Trousseau Hospital, Tours, France.
Goupille
P
P
Jattiot
F
F
Cotty
P
P
Lapierre
F
F
Valat
J P
JP
Amouroux
J
J
Benatre
A
A
D001706:Biopsy; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D015299:Discitis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D002097:C-Reactive Protein