MANAGEMENT OF POSTOPERATIVE DISCITIS AFTER LUMBER DISCECTOMY

Objective: To analyze patients with postoperative discitis and their management
Material And Methods: This observational study was conducted at the department of Neurosurgery, Post-graduate
medical institute, Lady Reading Hospital Peshawar from Jan 2010 to December 2012. A total of 792 consecutive patients
who undergone lumber discectomy were included in the study irrespective of their age and gender. The patients
were assessed postoperatively for discitis up to 12 weeks. Those who developed discitis were managed and followed
up to 6 months in addition.
Results: We had total 792 patients who underwent lumbar discectomy of which 24 (3.03%) developed discitis. There
were 62.5% males and 37.5% females. Age of the patients ranged 21-64 years with the mean age of 39.8 years. Most
of the patients presented within 6 weeks after surgery. ESR, C- reactive proteins and MRI lumbar spine were done in
all 24 (100%) patients. Majority (70.8%) of patients with discitis was treated conservatively and the rest 29.2% needed
exploration. All these patients had posterior exploration of which 5 (20.8%) patients needed transpedicular fixation
(TPF) and 2 (8.3%) patients only debridement and lavage of the wound.
Conclusions: Postoperative discitis is comparatively a rare complication after lumber discitis and can be treated conservatively
in most of the cases. Operative intervention is necessary in patients failing conservative treatment.
Key Words: Disc space infection, discitis, lumbar discectomy, postoperative discitis