title: The role of minimally invasive spine surgery in the management of pyogenic spinal discitis.
abstract: BACKGROUND
  Diagnostic yields for spondylodiscitis from CT guided biopsy is low. In the recent years, minimally invasive surgery (MIS) has shown to have a low morbidity and faster recovery. For spinal infections, MIS surgery may offer an opportunity for early pain control while obtaining a higher diagnostic yield than CT-guided biopsies. The aim of this study was to review our patients who underwent MIS surgery for spinal infection and report outcomes.
  
  
  METHODS
  A retrospective review of seven patients who underwent MIS decompression and/or discectomy in the setting of discitis, osteomyelitis, spondylodiscitis, and/or an epidural abscess was identified. Patient data including symptoms, visual analog score (VAS), surgical approach, antibiotic regimen, and postoperative outcomes were obtained.
  
  
  RESULTS
  Of the 7 patients, 5 patients had lumbar infections and two had thoracic infections. All seven patients improved in VAS immediately after surgery and at discharge. The average VAS improved by 4.4 ± 1.9 points. An organism was obtained in 6 of the 7 (85%) patients by the operative cultures. All patients made an excellent clinical recovery without the need for further spine surgery. All patients who received postoperative imaging on follow-up showed complete resolution or dramatically improved magnetic resonance imaging changes. The follow-up ranged from 2 to 9 months.
  
  
  CONCLUSIONS
  MIS surgery provides an opportunity for early pain relief in patients with discitis, osteomyelitis, spondylodiscitis, and/or epidural abscess by directly addressing the primary cause of pain. MIS surgery for discitis provides a higher diagnostic yield to direct antibiotic treatment. MIS surgery results in good long-term recovery.
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Mazda K
authors.initials: MK
authors.lastname: Turel
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Mena
authors.initials: M
authors.lastname: Kerolus
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Harel
authors.initials: H
authors.lastname: Deutsch
keywords: Discitis; minimally invasive spine surgery; osteomyelitis; spinal infection; spondylodiscitis