title: Systematic review of the incidence of discitis after cervical discography.
abstract: BACKGROUND
  Cervical discography is not uniformly used in part because of the fear of discitis. Studies report widely varying rates of this life-threatening infection.
  
  
  OBJECTIVE
  The aim of this study was to estimate the incidence of discitis after cervical discography, delineate the consequences of discitis, and identify factors that may influence this complication.
  
  
  METHODS
  Meta-analysis.
  
  
  METHODS
  Studies pertaining to cervical discography were identified by a literature review and bibliographic search. These were screened for inclusion into the meta-analysis by two reviewers. Data were collected on a wide range of clinical and demographic variables including age, gender, morbidities, number of patients, number of discograms, use of prophylactic antibiotics, type of surgical prep, number of needles used, and the number of patients and discs infected. Primary data were used to calculate the incidence of discitis per patient and per disc.
  
  
  RESULTS
  Fourteen studies were included in the analysis. Both procedural details and demographic information on patients were missing from eight studies. The mean age of patients ranged from 41 to 47 years, and gender distribution varied greatly. Antibiotics use was reported in three studies. Cervical discography was complicated by postprocedural discitis in 22 of 14,133 disc injections (0.15%) and 21 of 4,804 patients (0.44%). Only one patient suffered from an infection at more than one spinal level.
  
  
  CONCLUSIONS
  The rate of discitis after cervical discography is relatively low. This can perhaps be further decreased by the use of prophylactic intradiscal antibiotics. Should the ability of cervical discography to improve surgical outcomes be proven, the fear of discitis should not preclude performance of disc provocation.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, 550 North Broadway, Baltimore, MD 21205, USA.
authors.forename: Shruti Gupta
authors.initials: SG
authors.lastname: Kapoor
authors.forename: Jeremy
authors.initials: J
authors.lastname: Huff
authors.forename: Steven P
authors.initials: SP
authors.lastname: Cohen
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000601:surgery*; D015299:Discitis / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000601:surgery*; D019637:Orthopedic Procedures / Q000009:adverse effects*