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Updated: Jun 20, 2026
Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
Percutaneous curettage and continuous irrigation for MRSA lumbar spondylodiscitis: a report of three cases
Yoshiki Yamagami1, Sei Shibuya, Satoshi Komatsubara
1Department of Orthopaedic Surgery, School of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kagawa 761-0793, Japan.
Abstract:
There has been a recent increase in pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus (MRSA) associated with an increasing number of compromised patients. As long as serious paralysis is absent, we recommend percutaneous curettage and continuous irrigation as an effective treatment for MRSA lumbar spondylodiscitis. Under local anesthesia, the affected lumbar discs were curetted using percutaneous nucleotomy, and tubes were placed for continuous irrigation. The period of continuous irrigation was generally 2 weeks. Infection was controlled after one procedure in two cases and after two procedures in one case. Postoperative radiography and magnetic resonance imaging (MRI) showed callus formation, normalized signal intensity in vertebral bodies, and regression of abscesses. Open surgery under general anesthesia has been considered risky in patients with poor performance status or old age. The present method, which is an application of needle biopsy, can be performed under local anesthesia and is minimally invasive.
Insights
Percutaneous curettage and continuous irrigation offer an effective, minimally invasive treatment for methicillin-resistant Staphylococcus aureus (MRSA) lumbar spondylodiscitis in patients without paralysis. This approach, performed under local anesthesia, successfully controlled infection in treated cases.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Minimally Invasive Surgery
Background:
- Pyogenic spondylitis, particularly from methicillin-resistant Staphylococcus aureus (MRSA), is increasing in compromised patients.
- Traditional open surgery for spondylodiscitis poses risks for elderly or frail patients.
Observation:
- A minimally invasive technique involving percutaneous curettage and continuous irrigation was applied to patients with MRSA lumbar spondylodiscitis.
- The procedure was performed under local anesthesia, utilizing percutaneous nucleotomy for disc curettage and tube placement for irrigation.
Findings:
- Infection was controlled in all treated cases, with one or two procedures.
- Postoperative imaging (radiography and MRI) confirmed callus formation, normalized vertebral body signal, and abscess regression.
Implications:
- Percutaneous curettage and continuous irrigation represent a viable, less invasive alternative to open surgery for MRSA lumbar spondylodiscitis.
- This method is suitable for patients with poor performance status or advanced age, offering effective infection control.