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Endoscopic Approach at Two Non-Sequential Levels in Lumbar Discitis.

Fabio Henrique P Da Silva1, Carlos Eduardo P Henriques1, Dennis L Moreira1

  • 1Neurosurgery, Hospital Naval Marcilio Dias, Rio de Janeiro, BRA.

Cureus
|March 21, 2022
PubMed
Summary

This case study highlights a challenging spondylodiscitis infection. Surgical intervention via endoscopy provided rapid pain relief and facilitated targeted antibiotic therapy.

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Area of Science:

  • Spinal Surgery
  • Infectious Diseases
  • Radiology

Background:

  • Spondylodiscitis, an infection of the spine, can be difficult to treat, especially when initial antibiotic therapy guided by blood and urine cultures proves ineffective.
  • This case involves a 70-year-old female with lumbar spondylodiscitis at L2-L3 and L5-S1, presenting with severe back pain and mobility issues.

Observation:

  • Initial antibiotic treatment based on blood and urine cultures led to temporary improvement, followed by clinical deterioration.
  • Magnetic resonance imaging (MRI) and spinal tomography confirmed spondylodiscitis in two non-sequential lumbar segments.

Findings:

  • Surgical intervention using a full-endoscopic transforaminal approach was performed for debridement and sample collection.
  • Post-operative cultures of disc fragments revealed different bacterial species than initially identified.
Keywords:
antibiotic usagediscitisendoscopylower back painlumbar spine surgery

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  • The patient experienced immediate pain relief and regained mobility after the endoscopic procedure.

    • Implications:

    • Endoscopic spine surgery offers a minimally invasive option for diagnosing and treating refractory spondylodiscitis.
    • Accurate microbiological diagnosis from surgical samples is crucial for effective antibiotic selection.
    • This approach can lead to faster recovery and reduced hospital stays for spinal infections.