[Postoperative spondylodiscitis as the cause of failed-back syndrome--clinical aspects, diagnosis, therapy]

Postoperative lumbar spondylodiscitis can cause a failed back syndrome. With 0.1 to 3% according to the literature it belongs to the rarer complications following lumbar disc surgery. We present the characteristic clinical picture and typical findings (ESR, plain X-rays, MR) with suspected spondylodiscitis on 19 patients (= 0.2% of 9492 operative interventions for lumbar disc prolapse from 1980 to 1990) and show MR tomography to be the most sensitive investigation. Principles of therapy consist of lumbar immobilisation with a light cast orthesis for an average of 12 weeks and additional antibiotic therapy up to two weeks beyond normalisation of ESR. Finally results of therapy are presented with a satisfying outcome in 84.2% of cases.