Percutaneous management of pyogenic spondylodiscitis using absorbable antibiotic carrier (STIMULAN®): preliminary results from a single-center study

  • 1Azienda Ospedaliera Universitaria Senese, Siena, Italy.
  • 2Massachusetts General Hospital, Boston, United States.
  • 3Santissima Trinità, Cagliari, Italy.
  • 4Azienda USL Toscana Sud Est, Grosseto, Italy.
  • 5Ospedale di Avezzano, L'Aquila, Italy.
  • 6University of Siena, Siena, Italy.
  • 7Azienda USL Toscana Nord-Ovest, Lucca, Italy.
  • 8Azienda Usl Toscana Centro, Firenze, Italy. zini.chiara@gmail.com.

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Abstract

PURPOSE

This study evaluates the feasibility of using a fully resorbable antibiotic carrier (STIMULAN®, Rapid Cure, Biocomposites Ltd, UK) for the targeted treatment of spondylodiscitis (SD) through percutaneous injection directly into the infection site.

MATERIAL AND METHODS

Between 2022 and 2024, 13 patients diagnosed with SD underwent percutaneous osteo-discal biopsy followed by intradiscal and intravertebral injection of tailored antibiotic-loaded calcium sulfate paste. Clinical assessments (VAS), laboratory markers (CRP and leukocyte counts), and MRI imaging were used to monitor outcomes up to 12 months.

RESULTS

The procedure achieved 100% technical success with no major complications. All patients showed significant symptom relief, with VAS scores decreasing from 8.2 at baseline to 3.5 at 12 months. Inflammatory markers improved consistently, particularly CRP, which dropped from 7.35 to 0.23 (p ≈ 0.00005).

CONCLUSIONS

These findings suggest that STIMULAN® enables safe, effective local antibiotic delivery in SD, with meaningful clinical and biomarker improvements. Nonetheless, larger multicenter studies are needed to validate these preliminary results and assess long-term efficacy.

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