Endoscopic Treatment of Lumbar Spondylodiscitis. Case Report and Literature Review
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Published:
Apr 24, 2023
Keywords:
Endoscopic surgery, lumbar spondylodiscitis
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Abstract
We describe the case of a 62-year-old male patient with multiple comorbidities who attended the outpatient clinic due to severe low back pain compatible with T12-L1-L2 spondylodiscitis. Endoscopy was performed with a left posterolateral approach and an all-inside technique for diagnostic and therapeutic purposes. A germ was isolated and treated with specific antibiotics. Due to the good clinical evolution, the patient was discharged 7 days after surgery with good pain management and home intravenous antibiotic therapy. A brief literature review is presented.
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de Zavalía, M., Sauri-Barraza, J.-C., Gobbi, E., Bañuelos Aluzzi, C. E., Carral Robles de León, E., & Callejas Ponce, E. (2023). Endoscopic Treatment of Lumbar Spondylodiscitis. Case Report and Literature Review. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 88(2), 199-207. https://doi.org/10.15417/issn.1852-7434.2023.88.2.1700
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Case Presentations
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References
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18. Parker LM, McAfee PC, Fedder IL, Weis JC, Geis WP. Minimally invasive surgical techniques to treat spine infections. Orthop Clin North Am 1996;27(1):183-99. PMID: 8539048
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20. Staatz G, Adam GB, Keulers P, Vorwerk D, Günther RW. Spondylodiskitic abscesses: CT-guided percutaneous catheter drainage. Radiology 1998;208(2):363-7. https://doi.org/10.1148/radiology.208.2.9680560
21. Vinicoff PG, Gutschik E, Hansen SE, Karle A, Rieneck K. [CT-guided spinal biopsy in spondylodiscitis]. Ugeskr Laeger 1998;160(41):5931-4. [En danés] PMID: 9786032
22. Abreu PGP, Lourenço JA, Romero C, D’Almeida GN, Pappamikail L, Lopes MF, et al. Endoscopic treatment of spondylodiscitis: systematic review. Eur Spine J 2022;31(7):1765-74. https://doi.org/10.1007/s00586-022-07142-w
23. Muthu S, Ramakrishnan E, Chellamuthu G. Is endoscopic discectomy the next gold standard in the management of lumbar disc disease? Systematic review and superiority analysis. Global Spine J 2021;11(7):1104-20. https://doi.org/10.1177/2192568220948814
24. Lewandrowski KU, Telfeian AE, Hellinger S, Ramírez León JF, Teixeira de Carvalho PS, Ramos MRF, et al.
Difficulties, challenges, and the learning curve of avoiding complications in lumbar endoscopic spine surgery. Int J Spine Surg 2021;15(suppl 3):S21-S37. https://doi.org/10.14444/8161
25. Pull terGunne AF, Cohen DB. Incidence, prevalence, and analysis of risk factors for surgical site infection following adult spinal surgery. Spine 2009;34(13):1422-8. https://doi.org/10.1097/BRS.0b013e3181a03013
26. Choi KC, Shim HK, Kim JS, Cha KH, Lee DC, Kim ER, et al. Cost-effectiveness of microdiscectomy versus
endoscopic discectomy for lumbar disc herniation. Spine 2019;19(7):1162-9.
https://doi.org/10.1016/j.spinee.2019.02.003
27. Jang JW, Lee DG, Park CK. Rationale and advantages of endoscopic spine surgery. Int J Spine Surg 2021;15(suppl 3):S11-S20. https://doi.org/10.14444/8160
Chemother 2010;65(Suppl 3):iii11–iii24. https://doi.org/10.1093/jac/dkq303
2. Márquez Sánchez P. Espondilodiscitis. Radiologia 2016;58(Suppl 1):50-9. https://doi.org/10.1016/j.rx.2015.12.005
3. Colmenero JD, Jiménez-Mejías ME, Reguera JM, Palomino-Nicás J, Ruiz-Mesa JD, Márquez-Rivas J, et al.
Tuberculous vertebral osteomyelitis in the new millennium: still a diagnostic and therapeutic challenge. Eur J Clin Microbiol Infect Dis 2004;23(6):477-83. https://doi.org/10.1007/s10096-004-1148-y
4. Sans N, Faruch M, Lapègue F, Ponsot A, Chiavassa H, Railhac JJ. Infections of the spinal column--spondylodiscitis. Diagn Interven Imaging 2012;93(6):520-9. https://doi.org/10.1016/j.diii.2012.04.003
5. Afshar M, Reilly RF. Spondylodiscitis in a patient on chronic hemodialysis. Nature reviews. Nephrology
2011;7(10):599-604. https://doi.org/10.1038/nrneph.2011.105
6. Cervan AM, Colmenero J de D, Del Arco A, Villanueva F, Guerado E. Spondylodiscitis in patients under
haemodyalisis. Int Orthop 2012;36(2):421-6. https://doi.org/10.1007/s00264-011-1433-1
7. Gerometta A, Bittan F, Rodriguez Olaverri JC. Postoperative spondilodiscitis. Int Orthop 2012;36(2):433-8. https://doi.org/10.1007/s00264-011-1442-0
8. Ishihama Y, Sakai T, Manabe H, Tezuka F, Yamashita K, Takata Y, et al. Debridement for infectious spondylodiscitis in a 9-year-old girl using full-endoscopic discectomy system: a case report and literature review. J Med Invest 2020;67(3.4):351-4. https://doi.org/10.2152/jmi.67.351
9. Ito M, Abumi K, Kotani Y, Kadoya K, Minami A. Clinical outcome of posterolateral endoscopic surgery for
pyogenic spondylodiscitis: results of 15 patients with serious comorbid conditions. Spine 2007;32(2):200-6. https://doi.org/10.1097/01.brs.0000251645.58076.96
10. Kim M, Kim HS, Oh SW, Adsul NM, Singh R, Kashlan ON, et al. Evolution of spinal endoscopic
surgery. Neurospine 2019;16(1):6-14. https://doi.org/10.14245/ns.1836322.161
11. Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine 2008;33(9):931-9. https://doi.org/10.1097/BRS.0b013e31816c8af7
12. Casimiro M. Short-term outcome comparison between full-endoscopic interlaminar approach and open minimally invasive microsurgical technique for treatment of lumbar disc herniation. World Neurosurg 2017;108:894-900.e1. https://doi.org/10.1016/j.wneu.2017.08.165
13. Birkenmaier C, Komp M, Leu HF, Wegener B, Ruetten S. The current state of endoscopic disc surgery: review of controlled studies comparing full-endoscopic procedures for disc herniations to standard procedures. Pain Physician 2013;16(4):335-44. PMID: 23877449
14. Agha RA, Fowler AJ, Saeta A, Barai I, Rajmohan S, Orgill DP, SCARE Group (2016). The SCARE Statement:
Consensus-based surgical case report guidelines. Int J Surg 2016;34:180-6. https://doi.org/10.1016/j.ijsu.2016.08.014
15. Yang SC, Fu TS, Chen LH, Chen WJ, Tu YK. Identifying pathogens of spondylodiscitis: percutaneous endoscopy or CT-guided biopsy. Clin Orthop Relat Res 2008;466(12):3086-92. https://doi.org/10.1007/s11999-008-0441-y
16. Chew FS, Kline MJ. Diagnostic yield of CT-guided percutaneous aspiration procedures in suspected spontaneous infectious diskitis. Radiology 2001;218(1):211-4. https://doi.org/10.1148/radiology.218.1.r01ja0621
17. Fouquet B, Goupille P, Jattiot F, Cotty P, Lapierre F, Valat JP, et al. Discitis after lumbar disc surgery. Features of “aseptic” and “septic” forms. Spine 1992;17(3):356-8. https://doi.org/10.1097/00007632-199203000-00019
18. Parker LM, McAfee PC, Fedder IL, Weis JC, Geis WP. Minimally invasive surgical techniques to treat spine infections. Orthop Clin North Am 1996;27(1):183-99. PMID: 8539048
19. Rankine JJ, Barron DA, Robinson P, Millner PA, Dickson RA. Therapeutic impact of percutaneous spinal biopsy in spinal infection. Postgrad Med J 2004;80(948):607-9. https://doi.org/10.1136/pgmj.2003.017863
20. Staatz G, Adam GB, Keulers P, Vorwerk D, Günther RW. Spondylodiskitic abscesses: CT-guided percutaneous catheter drainage. Radiology 1998;208(2):363-7. https://doi.org/10.1148/radiology.208.2.9680560
21. Vinicoff PG, Gutschik E, Hansen SE, Karle A, Rieneck K. [CT-guided spinal biopsy in spondylodiscitis]. Ugeskr Laeger 1998;160(41):5931-4. [En danés] PMID: 9786032
22. Abreu PGP, Lourenço JA, Romero C, D’Almeida GN, Pappamikail L, Lopes MF, et al. Endoscopic treatment of spondylodiscitis: systematic review. Eur Spine J 2022;31(7):1765-74. https://doi.org/10.1007/s00586-022-07142-w
23. Muthu S, Ramakrishnan E, Chellamuthu G. Is endoscopic discectomy the next gold standard in the management of lumbar disc disease? Systematic review and superiority analysis. Global Spine J 2021;11(7):1104-20. https://doi.org/10.1177/2192568220948814
24. Lewandrowski KU, Telfeian AE, Hellinger S, Ramírez León JF, Teixeira de Carvalho PS, Ramos MRF, et al.
Difficulties, challenges, and the learning curve of avoiding complications in lumbar endoscopic spine surgery. Int J Spine Surg 2021;15(suppl 3):S21-S37. https://doi.org/10.14444/8161
25. Pull terGunne AF, Cohen DB. Incidence, prevalence, and analysis of risk factors for surgical site infection following adult spinal surgery. Spine 2009;34(13):1422-8. https://doi.org/10.1097/BRS.0b013e3181a03013
26. Choi KC, Shim HK, Kim JS, Cha KH, Lee DC, Kim ER, et al. Cost-effectiveness of microdiscectomy versus
endoscopic discectomy for lumbar disc herniation. Spine 2019;19(7):1162-9.
https://doi.org/10.1016/j.spinee.2019.02.003
27. Jang JW, Lee DG, Park CK. Rationale and advantages of endoscopic spine surgery. Int J Spine Surg 2021;15(suppl 3):S11-S20. https://doi.org/10.14444/8160