Percutaneous transpedicular discectomy and drainage in pyogenic spondylodiscitis.

Spondylodiscitis normally heals itself, but it can cause bone destruction leading to deformity and often pain. Debridement of these infections by percutaneous transpedicular discectomy with access from adjacent caudal pedicles can accelerate natural healing and prevent progression to bone destruction and deformity. We outline this technique and discuss a series of 28 patients treated using a percutaneous transpedicular approach to obtain culture and histopathology specimens, permit drainage and antibiotic irrigation, and provide a channel for granulation tissue to invade the infected space. This procedure is safe and effective, but it is contraindicated for epidural abscess or granulation tissue-induced neurocompression and it is ineffective against extensive bone destruction.

[1]  K. Yone,et al.  Percutaneous Suction Aspiration and Drainage for Pyogenic Spondylitis , 2000 .

[2]  A. Hadjipavlou,et al.  Hematogenous pyogenic spinal infections and their surgical management. , 2000, Spine.

[3]  P. Adegboyega,et al.  Pyogenic spondylodiskitis: a radiologic/pathologic and culture correlation study. , 2000, Archives of pathology & laboratory medicine.

[4]  G. Adam,et al.  Diagnostic and therapeutic management of lumbar and thoracic spondylodiscitis – an evaluation of 59 cases , 2000, Archives of Orthopaedic and Trauma Surgery.

[5]  P. Kambin,et al.  Imaging guided minimally invasive surgery for low back pain sciatica and spinal infection , 1999 .

[6]  K. Rieneck,et al.  [CT-guided spinal biopsy in spondylodiscitis]. , 1998, Ugeskrift for læger.

[7]  S. Arya,et al.  Percutaneous transpedicular automated nucleotomy for debridement of infected discs. , 1998, Journal of vascular and interventional radiology : JVIR.

[8]  M. Weber,et al.  [Percutaneous CT-controlled puncture and drainage of spondylodiscitis--a minimally invasive method]. , 1998, Zeitschrift für Orthopädie und ihre Grenzgebiete.

[9]  F. Magerl,et al.  The Value of Percutaneous Transpedicular Vertebral Bone Biopsies for Histologic Examination: Results of an Experimental Histopathologic Study Comparing Two Biopsy Needles , 1996, Spine.

[10]  A. Aboulafia,et al.  Percutaneous Transpedicular Biopsy of Vertebral Body Lesions , 1996, Spine.

[11]  P. Lander,et al.  Percutaneous transpedicular biopsy of the spine. , 1994, Spine.

[12]  J. Brugman,et al.  Percutaneous Discetomy for the Treatment of Bacterial Discitis , 1994, Spine.

[13]  W. Watters,et al.  Percutaneous diskectomy for disk space infections. , 1994, Journal of the Southern Orthopaedic Association.

[14]  N. Lebwohl,et al.  Imaging of infection of the lumbosacral spine , 1993 .

[15]  K. Gill,et al.  Automated percutaneous discectomy. Long-term clinical experience with the Nucleotome system. , 1993, Acta orthopaedica Scandinavica. Supplementum.

[16]  R. Wisneski Infectious disease of the spine. Diagnostic and treatment considerations. , 1991, The Orthopedic cllinics of North America.

[17]  G. Onik,et al.  Automated percutaneous biopsy in postoperative diskitis: a new method. , 1990, AJNR. American journal of neuroradiology.

[18]  B. Vernon‐roberts,et al.  latrogenic Discitis: The Role of Intravenous Antibiotics in Prevention and Treatment: An Experimental Study , 1989, Spine.

[19]  S. Emery,et al.  Treatment of hematogenous pyogenic vertebral osteomyelitis with anterior debridement and primary bone grafting. , 1989, Spine.

[20]  M. Ivey,et al.  Arthroscopic debridement of the knee for septic arthritis. , 1985, Clinical orthopaedics and related research.

[21]  R. Jackson The septic knee--arthroscopic treatment. , 1985, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[22]  V. Goldberg,et al.  Pyogenic and fungal vertebral osteomyelitis with paralysis. , 1983, The Journal of bone and joint surgery. American volume.

[23]  H. Yuan,et al.  Management and outcome of pyogenic vertebral osteomyelitis. , 1978, Clinical orthopaedics and related research.

[24]  T. Taylor,et al.  Antibiotics in the management of postoperative disc space infections. , 1978, The Australian and New Zealand journal of surgery.