title: Surgical Strategies for Spondylodiscitis due to Lumbar Disc Surgery.
abstract: OBJECTIVE
  Despite different surgical treatment protocols at different centers for spondylodiscitis due to lumbar surgery, there is no consensus on its surgical indications. In this study, we aimed to clarify the steps to be followed in the management and treatment of postoperative spondylodiscitis.
  
  
  METHODS
  The data of 20 cases with postoperative spondylodiscitis were evaluated. C-reactive protein (CRP) was used for diagnosis and follow-up. According to culture results of the infected material obtained from the operated cases, appropriate antibiotic treatment was initiated. In non-operated cases, parenteral empirical antibiotic treatment was implemented. Surgical treatment was planned for cases with clinical and radiological instability, abscess on imaging and those who were nonrespondent to empirical antibiotic treatment. For the cases that clinically recovered and had normal CRP levels, oral antibiotic treatment was continued after parenteral antibiotic treatment.
  
  
  RESULTS
  Of the cases; 13 were male (65%) and 7 were femals (35%). The mean age was 56.3 years (32-74). The most prevalent complaints in referral were waist and leg pain. Except one, all cases had increased CRP levels. All patients had spondylodiscitis on magnetic resonance imaging. Seven had radiological and clinical instability and 3 had epidural abscess. The most commonly growing microorganism in culture was Staphylococcus aureus. Surgical treatment was applied to seven cases and medical treatment to 13 cases.
  
  
  CONCLUSIONS
  In cases with waist pain in the postoperative period, the first potential diagnosis to be considered is spondylodiscitis. Surgical treatment should be implemented for cases resistant to empirical antibiotic treatment, with abscess on imaging, or with lumbar instability.
authors: Erciyes University, School of Medicine, Department of Neurosurgery, Kayseri, Turkey.
authors: Ahmet
authors: A
authors: Kucuk
authors: Mustafa
authors: M
authors: Karademir
authors: Abdulfettah
authors: A
authors: Tumturk
authors: Halil
authors: H
authors: Ulutabanca
authors: Baris Derya
authors: BD
authors: Ercal
authors: Serkan
authors: S
authors: Senol
authors: Ahmet
authors: A
authors: Menku
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism; D015299:Discitis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D020802:Epidural Abscess / Q000601:surgery; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein