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Discitis following lumbar surgery.

M D Bircher1, T Tasker, C Crawshaw

  • 1St. George's Hospital, Tooting, London.

Spine
|January 1, 1988
PubMed
Summary
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Postoperative discitis, an infection of the spine, is often missed. An elevated erythrocyte sedimentation rate (ESR) after spinal surgery can indicate this serious condition, aiding early diagnosis.

Area of Science:

  • Orthopaedic Surgery
  • Infectious Disease
  • Diagnostic Medicine

Background:

  • Postoperative discitis is a known complication of spinal surgery.
  • Diagnosis is often delayed, leading to poorer patient outcomes.
  • Clinical presentation can be subtle and easily overlooked.

Purpose of the Study:

  • To investigate the diagnostic utility of erythrocyte sedimentation rate (ESR) for postoperative discitis.
  • To identify key indicators for early detection of discitis after spinal procedures.
  • To improve the diagnostic rate of postoperative discitis.

Main Methods:

  • Retrospective review of six discitis cases.
  • Prospective study of 26 patients undergoing discectomy or fusion.
  • Serial measurement of erythrocyte sedimentation rate (ESR) preoperatively and at 1, 2, and 6 weeks postoperatively.

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Main Results:

  • All patients with discitis had an ESR > 50 at ≥2 weeks post-surgery.
  • An ESR > 50 at 2 weeks post-surgery was a significant indicator.
  • Increasing back pain combined with elevated ESR warrants further investigation.

Conclusions:

  • Routine ESR monitoring post-spinal surgery can aid in early discitis detection.
  • An elevated ESR (e.g., >50) 2 weeks after surgery, especially with back pain, strongly suggests discitis.
  • Timely ESR measurement can prevent delayed diagnosis and improve management of postoperative discitis.