title: Percutaneous curettage and continuous irrigation for MRSA lumbar spondylodiscitis: a report of three cases.
abstract: There has been a recent increase in pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus (MRSA) associated with an increasing number of compromised patients. As long as serious paralysis is absent, we recommend percutaneous curettage and continuous irrigation as an effective treatment for MRSA lumbar spondylodiscitis. Under local anesthesia, the affected lumbar discs were curetted using percutaneous nucleotomy, and tubes were placed for continuous irrigation. The period of continuous irrigation was generally 2 weeks. Infection was controlled after one procedure in two cases and after two procedures in one case. Postoperative radiography and magnetic resonance imaging (MRI) showed callus formation, normalized signal intensity in vertebral bodies, and regression of abscesses. Open surgery under general anesthesia has been considered risky in patients with poor performance status or old age. The present method, which is an application of needle biopsy, can be performed under local anesthesia and is minimally invasive.
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kagawa 761-0793, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Yamagami
authors.forename: Sei
authors.initials: S
authors.lastname: Shibuya
authors.forename: Satoshi
authors.initials: S
authors.lastname: Komatsubara
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Nobuo
authors.initials: N
authors.lastname: Arima