Value of CT-guided biopsy in the diagnosis of septic discitis

To determine the role of CT-guided biopsy in the management of cases of infective discitis.

Data were examined from a retrospective case series of CT-guided biopsies for the 5-year period ending June 2006.

98 CT-guided biopsies were performed in the study period on 103 patients. Malignancy was diagnosed in 49 episodes. Discitis and paravertebral abscess accounted for 27 cases. Culture was positive in nine of 25 (36%) samples received by the microbiology laboratory. Staphylococcus aureus (four cases) and Mycobacterium tuberculosis (three cases) were the most frequent organisms isolated, followed by group G streptococci and coagulase-negative staphylococci (one case each). Blood cultures were diagnostic in a further nine patients. The main reason for a negative culture was prior antimicrobial therapy. The biopsy changed management in 9/25 (36%) of cases. There were no reported adverse events.

Septic discitis is a serious condition with a wide variety of infective causes. CT-guided biopsy is a useful tool when the diagnosis of infectious spinal infection is considered in terms of commencing and targeting therapy, and it is a safe and well-tolerated procedure.