Spondylodiskitic abscesses: CT-guided percutaneous catheter drainage

To determine whether computed tomographically (CT) guided percutaneous catheter drainage of spondylodiskitic abscesses is an appropriate and effective alternative to surgery.

CT-guided percutaneous catheter drainage was performed in 21 patients (16 men, five women; age range, 24-81 years) with 33 spondylodiskitic abscesses. Nine intradiskal, 12 paravertebral, and 12 psoas abscesses were drained with 5.6-14.0-F catheters. In 29 cases, the catheter was inserted by using the Seldinger technique in four cases, a trocar technique was used. All patients underwent follow-up CT or magnetic resonance imaging examinations for 6 months.

Successful placement of the drainage catheter was achieved in each patient without procedural complications. The duration of drainage was 4-56 days (average duration, 26.8 days). Three of 33 catheters were changed because of insufficient drainage; one of the 33 catheters had to be reinserted because of dislocation. Two patients underwent surgery for stabilization of the spine with the drainage catheter in place. In 16 of the 21 patients, specific organisms were isolated; thus, definitive medical therapy was possible. Complete evacuation of all abscesses was achieved initially, with no evidence of recurrence during the follow-up.

CT-guided percutaneous catheter drainage is an efficient and safe procedure in the management of spondylodiskitic abscesses.