Post Operative Discitis- A Review of 10 Patients in A Tertiary Care Neurosurgical Unit.

Abstract

Background: Postoperative discitis is an uncommon complication of spine surgery with estimated incidence rate usually less than 1% 1 . It is defined as primary infection of nucleus pulposus with secondary involvement of cartilaginous end plates and adjacent vertebral bodies following lumbar disc surgeries 2 . Early diagnosis based on clinical, laboratory, imageological findings and identification of causative agent and appropriate management of discitis is essential to reduce morbidity. The aim of this study was to identify the associated risk factors, most common level of discitis and outcome of conservative management in cases of post operative discitis of single level discectomy. Materials & Methods:The study was carried out retrospectively over a period of 6 months from Jan 2014 to Dec 2015. Total 192 cases were operated electively for single level lumbar spine disorders. Post op discitis was established by clinical, laboratory & radiological findings. Results: During the study period 192 single level discectomies were performed. Out of 192 patients 10 patients(5.2%) were suffered from discitis. The mean age of patients of postop discitis was 44 years with 4 women and 6 men. Among these 10 patients 3 were diabetic under good glycemic control. Most common clinical presentation is moderate to severe low backache. Out of 10 patients 7patients corresponds to L4/L5 level. After 6 weeks of antibiotic therapy (3 weeks i.v.+3 weeks oral) with complete bed rest all patients were improved symptomatically. After 6 months of follow up all patients were able to carry on their daily activities. Conclusions: Post operative discitis is an uncommon but serious complication of disc surgeries. Early diagnosis and appropriate antibiotic therapy along with immobilisation is essential in the management.