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Infection of intervertebral discs after operation
Abstract:
Infection of the intervertebral space is a rare complication of operation on the disc (Ford and Key 1955). It occurred in five cases in a series of 650 operations for lumbar disc protrusion done by two of the authors of this paper--an incidence of 0-8%. Symptoms began between seven and twelve days after operation. After initial relief of the original sciatic pain, the patients developed severe back pain and muscle cramps in the legs. Straight-leg raising became much more limited than before operation. The erythrocyte sedimentation rate was raised in all cases. The diagnosis was confirmed by rescreening the Myodil, when an indentation was seen opposite the intervertebral space from which the disc had been excised. Early removal of infected material from the disc space resulted in complete relief of pain and cure of the infection.
Insights
Postoperative disc space infection is a rare complication after lumbar disc surgery. Early diagnosis and surgical removal of infected material can lead to complete pain relief and infection cure.
Area of Science:
- Neurosurgery
- Infectious Disease
Background:
- Infection of the intervertebral space is a rare but serious complication following operative procedures on the intervertebral disc.
- This complication can lead to significant patient morbidity, including persistent pain and neurological deficits.
Purpose of the Study:
- To report the incidence, clinical presentation, diagnostic methods, and treatment outcomes of postoperative intervertebral disc space infections.
Main Methods:
- A retrospective review of 650 patients who underwent lumbar disc protrusion surgery.
- Analysis of five cases presenting with symptoms suggestive of disc space infection.
- Diagnostic confirmation using Myodil (iophendylate) rescreening and erythrocyte sedimentation rate (ESR).
Main Results:
- An incidence of 0.8% for postoperative disc space infection was observed in the series.
- Symptoms, including severe back pain and leg cramps, appeared 7-12 days post-operation.
- Elevated ESR and characteristic findings on Myodil rescreening confirmed the diagnosis in all cases.
Conclusions:
- Postoperative disc space infection, though rare, requires prompt recognition and management.
- Early surgical intervention involving the removal of infected disc material is effective in achieving pain relief and resolving the infection.