Related Experiment Videos
The role of laparoscopic biopsies in lumbar spondylodiscitis
J M Corpataux1, N Halkic, M Wettstein
1Department of Surgery, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.
Abstract:
The infection of an intervertebral disk is a serious condition. The diagnosis often is elusive and difficult to make. It is imperative to have appropriate microbiologic specimens before the initiation of treatment. We report the case of a 51-year-old woman with lumbar spondylodiscitis caused by infection after the placement of an epidural catheter for postoperative analgesia. A spinal magnetic resonance imaging (MRI) scan confirmed the diagnosis, but computed tomography (CT)-guided fine-needle biopsy did not yield adequate material for a microbiologic diagnosis. Laparoscopic biopsies of the involved disk provided good specimens and a diagnosis of Propionibacterium acnes infection. We believe that this minimally invasive procedure should be performed when CT-guided fine-needle biopsy fails to yield a microbiologic diagnosis in spondylodiscitis.
Insights
Diagnosing spinal disk infections can be challenging. Laparoscopic biopsy is recommended when CT-guided biopsy fails to obtain adequate samples for diagnosing spondylodiscitis, particularly Propionibacterium acnes infections.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Radiology
Background:
- Intervertebral disk infections (spondylodiscitis) are serious conditions with often elusive diagnoses.
- Accurate microbiologic diagnosis is crucial before initiating treatment for spinal infections.
Observation:
- A case of a 51-year-old woman with lumbar spondylodiscitis following epidural catheter placement is presented.
- Spinal magnetic resonance imaging (MRI) confirmed the diagnosis, but computed tomography (CT)-guided fine-needle biopsy yielded insufficient material.
- Laparoscopic biopsies of the infected disk provided adequate specimens for microbiologic analysis.
Findings:
- The infection was diagnosed as Propionibacterium acnes.
- Laparoscopic biopsy proved effective in obtaining diagnostic material when CT-guided biopsy failed.
Implications:
- Laparoscopic biopsy is a valuable minimally invasive option for diagnosing spondylodiscitis when conventional methods are inadequate.
- This approach can ensure timely and accurate microbiologic diagnosis, guiding appropriate treatment for challenging spinal infections.