[Spondylodiscitis following lumbar intervertebral disk surgery. Clinical aspects--diagnosis--therapy]

From 1980 to 1986 6632 operations of the lumbar spine due to disc prolapse were carried out by the Department of Neurosurgery of the hospital of the Technical University of Munich. During this period we saw 14 cases of postoperative spondylodiscitis. Patients' main symptom was increasing low back pain. Physical examination showed difficulty in forward flexion of the body. The blood sedimentation rate was always examined: an average increase to 42/66 mm was recorded. X-ray examination of the lumbar spine and magnetic resonance imaging proved to be the most sensitive methods of investigation, better than scintigram and computed tomography. Our therapeutic management consists of fixation in normal position with a "Light Cast" corset and additional antibiotic therapy with cephadroxil. In comparison to other therapy methods, i.e. restcure, the advantage for our patients is that they can stay at home and move about. Therapy must be continued until the blood sedimentation rate is normal and radiological signs of consolidation can be seen for at least over 10 weeks. Good long-term results were seen in all patients.