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Efficacy of Intradiscal Gentamicin in Preventing Disc Space Infection after Lumbar Discectomy
Bilal Khan1, Hubab Ali1, Syed Mansoor Shah1
1Department of Neurosurgery, Lady Reading Hospital Medical Teaching Institution, Peshawar, Pakistan.
Objective:
To determine the efficacy of intradiscal gentamicin in preventing postoperative discitis in lumbar spine surgery.
Study Design:
An observational study. Place and Duration of the Study: Department of Neurosurgery, Lady Reading Hospital Medical Teaching Institution, Peshawar, Pakistan, from January 2018 to April 2023.
Methodology:
Data were retrieved and analysed for patients who underwent open microdiscectomy of the lumbar spine performed by a single surgeon between January 2018 and April 2023. Cases operated until December 2020 did not receive intradiscal gentamicin and were grouped as non-gentamicin (NG), while those operated afterwards were grouped as gentamicin (G). Inclusion and exclusion criteria were strictly applied to reduce potential bias.
Results:
A total of 295 patients underwent surgery. The NG group comprised 165 patients, and the G group 130 patients. There were 151 males (51%) and 144 females (49%), with ages ranging from 20 to 67 years (mean age: 43.4 years). L4-L5 was the most commonly affected level (59%), followed by L5-S1 (38%). The NG group showed a discitis frequency of 6.6% (11/165), whereas the G group had a significantly lower rate of 1.5% (2/130, p = 0.033).
Conclusion:
Intradiscal gentamicin may be effective in reducing the incidence of postoperative discitis following open microdiscectomy.
Key Words:
Discitis, Infection, Gentamicin, Efficacy, Local antibiotics.
