Postoperative spondylodiscitis: Five-year, single-center retrospective analysis. Is it really postoperative?

INTRODUCTION

Postoperative spondylodiscitis (POSD) is not uncommon. The incidence of POSD varies between 0.21- 3.6% In this study, it was aimed to examine the clinical findings, diagnosis and treatment of postoperative spondylodiscitis (POSD).

MATERIALS AND

METHODS

Between September 2017 and October 2022, 37 patients were included in the study, who applied to the Infectious Diseases and Clinical Microbiology Clinic of the XXX Hospital and had POSD infection and were followed-up/treated as outpatients or inpatients. The following were examined: symptoms, physical examination findings, contrast-enhanced spinal MRI (magnetic resonance imaging) findings of the patients, laboratory findings, PPD (purified protein derivative) and QuantiFERON TB-Gold test and blood cultures. The antibiotics that were started and the clinical and radiological response of the patients to the treatment were evaluated.

RESULTS

Of the patients 25 (67.6%) were female and 12 (32.3%) were male. The mean time to develop POSD after surgery was 44.8 months. In our study, we found that laboratory tests were not significant in diagnosing POSD other than C-reactive protein(CRP). Teicoplanin and ciprofloxacin were given to all patients except one patient with positive brucella slide and tube agglutination. With this treatment, clinical and radiological improvement was observed in 24 patients. The treatment of 13 patients, including the patient who was given Brucella treatment, was changed due to the lack of clinical and radiological improvement, and anti-tuberculosis treatment was started and recovery was achieved. The mean duration of the treatment was 3.5 months in the pyogenic POSD group and 9.5 months in the POSD patient group that recovered with anti-tuberculosis therapy.

CONCLUSION

It Should be kept in mind that in cases where the POSD patients do not benefit from empirical treatment, the causative agent may be an agent other than the common microorganisms, for example M. tuberculosis, and if the agent cannot be detected, finding the diagnosis from treatment is also an option.