The role of laparoscopic biopsies in lumbar spondylodiscitis.
The infection of an intervertebral disk is a serious condition. The diagnosis often is elusive and difficult to make. It is imperative to have appropriate microbiologic specimens before the initiation of treatment. We report the case of a 51-year-old woman with lumbar spondylodiscitis caused by infection after the placement of an epidural catheter for postoperative analgesia. A spinal magnetic resonance imaging (MRI) scan confirmed the diagnosis, but computed tomography (CT)-guided fine-needle biopsy did not yield adequate material for a microbiologic diagnosis. Laparoscopic biopsies of the involved disk provided good specimens and a diagnosis of Propionibacterium acnes infection. We believe that this minimally invasive procedure should be performed when CT-guided fine-needle biopsy fails to yield a microbiologic diagnosis in spondylodiscitis.
Corpataux
J M
JM
Department of Surgery, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.
Halkic
N
N
Wettstein
M
M
Dusmet
M
M
D000767:Anesthesia, Epidural / Q000009:adverse effects; D001707:Biopsy, Needle / Q000379:methods*; D015299:Discitis / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010149:Postoperative Pain / Q000628:therapy; D011425:Propionibacterium acnes / Q000302:isolation & purification; D014057:Tomography, X-Ray Computed