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Full-Endoscopic Isolation Zone Technique for the Treatment of Lumbar Disc Herniation
Published on: April 7, 2023
New needle biopsy technique for lumbar pyogenic spondylodiscitis
Motohide Shibayama1, Masashizu Nagahara, Gou Kawase
1Department of Orthopedic Surgery, Toyokawa City Hospital, Aichi, Japan. xydxs686@yahoo.co.jp
Study Design:
Case series.
Objective:
To improve the isolation rate for pyogenic spondylodiscitis, we developed a new needle biopsy technique.
Summary Of Background Data:
The biggest problem in treating lumbar pyogenic spondylodiscitis is a low success rate in isolating a causative microorganism. The rates have been reported 42% to 64%.
Methods:
There are 3 steps: (A) Insert a 21-G needle as for discography, aspirate pus or fluid as specimen. (B) If step A fails, inject saline and collect fluid as reflux. (C) If step B fails, insert another needle into the disc, inject saline and collect reflux from the other needle. We applied this approach to 12 patients with a mean age of 64.3 years.
Results:
We were able to collect fluid samples in all cases and the culture was positive in 11 cases (91.6%). Staphylococcus aureus was the most frequently identified organism (41.7%).
Conclusion:
This simple method improved the isolation rate and should improve the treatment of lumbar pyogenic spondylodiscitis.