Related Experiment Video
Updated: Jun 21, 2026
05:42
Full-Endoscopic Isolation Zone Technique for the Treatment of Lumbar Disc Herniation
Published on: April 7, 2023
The prevention of discitis during discography
Shiv K Sharma1, Jonathan O Jones, Pablo P Zeballos
1Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9806, USA. Shiv.Sharma@UTSouthwestern.edu
Summary
Preventing discitis, a feared complication of discography, lacks clear guidelines. Current evidence suggests sterile technique alone is comparable to antibiotic use, but animal studies support prophylaxis before inoculation. Needle techniques with stylets are preferred.
Area of Science:
- Spinal diagnostics
- Infectious disease prevention
- Medical procedure safety
Background:
- Discitis is a severe complication of discography, with limited evidence on effective prevention strategies.
- Current practices for preventing discitis, including intravenous (IV) and intradiscal antibiotics, lack consensus.
- Existing research on antibiotic use for discitis prevention is conflicting and often insufficient.
Purpose of the Study:
- To synthesize existing evidence on discitis prevention during discography.
- To review basic science, animal, and clinical data related to infection prevention.
- To identify areas for future research in discitis prevention.
Main Methods:
- A comprehensive literature review was performed.
- Databases searched included MEDLINE and SCOPUS for relevant studies and case reports.
- A meta-analysis was not feasible due to limited randomized controlled trials and data scarcity.
Main Results:
- Seven articles focused on discitis prevention; none were randomized controlled trials.
- Two prospective non-randomized trials, three retrospective case series, and two reviews were identified.
- Fifteen articles examined antibiotic penetration and efficacy in intervertebral discs; 14 reported discitis incidence.
Conclusions:
- Clinical evidence does not conclusively show IV or intradiscal antibiotics reduce discitis rates compared to sterile technique alone.
- Animal models suggest prophylactic antibiotics are beneficial before intervertebral disc inoculation.
- Single- and double-needle techniques utilizing stylets are more effective than non-styletted methods.
Related Concept Videos
01:27Degenerative Disc Disease I: Introduction
Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...
01:23Degenerative Disc Disease ll: Pathophysiology
The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
01:14Imaging Studies I: CT and MRI
Introduction: MRI and CT scans are crucial advancements in medical imaging techniques, playing a vital role in diagnosing conditions related to the gastrointestinal (GI) system. Each scan serves distinct purposes, targets specific areas, and requires unique nursing duties.
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:29Endocarditis IV: Nursing Management
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
01:17Transmission-based Precautions I: Contact, Enteric, and Droplets
Transmission-based precautions are for patients known to be infected or suspected to be infected or colonized with organisms that pose a significant risk to others. Some transmission-based precautions include contact, enteric, and droplet.
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
01:29Herniated Intervertebral Disc l: Introduction
Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...