Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Discitis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources
PubMed2004

[Low back pain among children and adolescents].

OBJECTIVES: We presented our experience with the diagnosis and treatment of low back pain in children. METHODS: We retrospectively reviewed 29 children (15 girls, 14 boys; mean age 12 years; range 9 to 17 years) who were treated for low back pain and had appropriate follow-ups. Etiologic causes were sought by clinical evaluation, radiologic studies, and laboratory tests. Patients with unknown etiology underwent symptomatic treatment. The mean follow-up period was 42 months (range 12 to 96 months). RESULTS: Etiology was determined in 26 patients (89%), which included spondylolysis/spondylolisthesis (n=8), Scheuermann's disease (n=6), neoplasia (n=5), discitis/vertebral osteomyelitis (n=4), and lumbar disc herniation (n=3). Spondylolysis was managed conservatively, except for one patient who had in situ spinal fusion for associated spondylolisthesis. Five patients with Scheuermann's disease were treated conservatively, while one patient required spinal fusion. Surgical treatment with biopsy, curettage, and bone grafting was performed for all neoplasias, but one which was followed-up conservatively. Two patients with discitis were managed with antibiotic treatment and two patients with vertebral osteomyelitis (Pott's abscess) underwent both medical treatment and surgical drainage and stabilization with strut graft. Lumbar disc herniation was treated conservatively in two patients, while one had surgical treatment with excision of disc fragments and limited laminectomy. Finally, all the patients became asymptomatic on final examinations. CONCLUSION: Serious consideration should be given to persistent low back pain in children. Clinical, radiologic, and laboratory findings can be elaborated into etiologic diagnoses and complete relief can be achieved with appropriate treatment.

Adolescent↗
PubMed2004

Percutaneous annuloplasty in the treatment of discogenic pain: retrospective evaluation of one year follow-up.

In this study, we have evaluated clinical results of the discTRODE system, in 15 patients with discogenic pain. All procedures were performed under sterile conditions with fluoroscopic guidance. After identifying the disc space under fluoroscopy, the introducer of the discTRODE was introduced using a tunneled vision. After inserting the introducer; navigable, semi-rigid discTRODE catheter was advanced through the introducer and directed medially and contralaterally along the posterior nuclear-annular interface. The SMK Thermocouple Electrode was placed in the outer-annulus on the contralateral side so as to monitor local tissue temperature. The treatment temperature was manually increased in a step-wise progression from 50 degrees C to 65 degrees C. Patient outcomes were evaluated during follow-up visits at 1, 3, 6 and 12th months post-procedure. Before the procedure and at each visit during the follow-up period, patients completed Visual Analogue Pain Scale (VAS) and Short Form-36 Health Status Questionnaire (SF-36). Annuloplasty was performed without difficulty in all patients, there were no complications associated with disc puncture such as discitis or disc rupture. Symptoms improved in 10 of 15 (66.6 %) of the patients on the SF-36 Physical Function subscale, in 9 of 15 (60 %) on the SF-36 Bodily Pain subscale and in 9 of 15 (60 %) on the VAS scores. 5 of 15 of the patients did not show improvement on any scale. This technique seems to be a reliable method for patients complaining of discogenic pain. However, prospective randomized controlled studies comparing different approaches are needed.

Adult↗
PubMed1979

Pyogenic infections of the adult spine.

A retrospective analysis of 61 patients forms the basis for this paper's comment on three major types of pyogenic spinal disease. The first group consists of 22 patients with vertebral osteomyelitis and intervertebral discitis. The second group comprises 22 patients in whom the diagnosis of pyogenic spinal disease was made only after failure of discectomy. In retrospect they were shown to have atypical degenerative disc disease and were similar to the first group. The third group of 17 patients, while demonstrating some similarities to the second group, represents true postdiscectomy wound infection. An understanding of the clinical presentation and pathophysiology of pyogenic disease of the spine allows it to be distinguished preoperatively from degenerative disc disease which superficially it resembles. Further, true postdiscectomy wound infection can be distinguished from pyogenic spinal disease misdiagnosed preoperatively. The differences in the results of treatment of these three groups warrant such distinctions.

Back Pain↗
PubMedDate not supplied

[Spinal epidural abscess caused by Acinetobacter baumannii mimicking a herniated lumbar disc].

INTRODUCTION: A vertebral epidural abscess usually offers a very varied clinical picture of systemic involvement with signs of infection, general malaise and neurological focus. It is diagnosed by means of magnetic resonance imaging, which reveals large lesions with frequent involvement of soft tissues and peripheral contrast enhancement. CASE REPORT: A 35-year-old male with lumbar-radicular pain in the right S1 with Lasègue's sign at 20 degrees on the right side and abolition of the Achilles' reflex. Magnetic resonance imaging showed an extradural lesion in L5-S1, dependent on the disc space, which suggested a herniated disc. The rest of the anamnesis, explorations and analyses were normal except for a slightly high erythrocyte sedimentation rate. The patient was submitted to surgery and an epidural abscess was observed from which an Acinetobacter baumanii was recovered. Treatment was established with antibiotics and a rigid lumbosacral orthosis. At three months clear signs of discitis were observed in magnetic resonance images; these were completely resolved at eight months, when the patient was asymptomatic. CONCLUSIONS: Epidural abscess must be included in the differential diagnosis of a herniated disc because in the early phases it can give rise to symptoms of lumbar-radicular pain that are identical to those caused by a herniated lumbar disc. This is the first case of an epidural abscess produced by A. baumanii.

Acinetobacter Infections↗
PubMed2005

Clinical characteristics of invasive Haemophilus aphrophilus infections.

Haemophilus aphrophilus, an oral fastidious Gram-negative commensal with low pathogenicity, is a member of the HACEK group (H. aphrophilus, H. paraphrophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella spp.), and a rare cause of human infections. We reviewed the characteristics of 8 cases of H. aphrophilus infections diagnosed in our hospital from 1990-2003, and an additional 20 cases identified from the MEDLINE database, from 1990 to 2003. Their mean age was 47.4 years (range, 7-73 years), and 21 cases (75%) were male. The major manifestation was bone and joint infections (9 cases, 32%), including osteomyelitis, discitis, epidural abscess, spondylodiscitis, septic arthritis and prevertebral infection. Seven cases (25%) presented with infective endocarditis, involving native valves, and one underwent valvular replacement. Of note, 3 cases (10%) had ophthalmic infections (endophthalmitis in 2 cases and canaliculitis in 1), and 2 of them had previous ophthalmic procedures. Other manifestations included bacteremia, meningitis, brain abscess, cervical lymphadenitis, facial cellulitis, empyema, and purulent pericarditis and tamponade. All patients except 1 survived. Recent dental procedure was recalled by 11 cases (39%), and may be a predisposing factor for invasive H. aphrophilus infection. Appropriate antimicrobial therapy, such as a beta-lactam/beta-lactamase inhibitor, ceftriaxone or cefotaxime or a fluoroquinolone, can lead to a favorable clinical outcome.

Adult↗
PubMed2005

Gunshot injuries of the spine--a review of 49 cases managed at the Groote Schuur Acute Spinal Cord Injury Unit.

UNLABELLED: The Acute Spinal Injury Unit, relocated from Conradie Hospital to Groote Schuur Hospital in mid-2003, admitted 162 patients in the first year of its existence. A large number of these injuries were the result of interpersonal violence, particularly gunshot wounds. AIM: To review patients with gunshot injuries to the spine, with reference to neurological injury, associated injuries, need for surgery and complications. METHODS: A comprehensive database is maintained to collect data on all spinal injury admissions. These data, as well as case notes and X-rays, were reviewed for all gunshot spine patients admitted to the Acute Spinal Injury Unit over a year. Forty-nine patients were identified. Thirty-eight were male and 11 female with an average age of 27.5 years (range 15-51 +/- 8.53). The average stay in the acute unit was 30 (4-109 +/- 28) days. RESULTS: The spinal injury was complete in 38 and incomplete in 8, with 3 having no neurological deficit. The level was cervical in 13, thoracic in 24 and lumbar in 12. Only 9 patients improved neurologically. The spine was considered stable in 43 cases. Stabilisation was performed in the 6 unstable cases. The bullets were removed in 11 cases as they were in the canal. There were 55 significant associated injuries, viz. 14 haemo-pneumothoraces, 16 abdominal visceral injuries, 3 vascular injuries, 4 injuries of the brachial plexus and 3 of the oesophagus, 2 tracheal injuries, 1 soft palate injury and 11 non-spinal fractures. Complications included 3 deaths and discitis in 3 cases, pneumonia in 6 and pressure sores in 6. CONCLUSION: Gunshot injuries of the spine are a prevalent and resource-intensive cause of paralysis. There is a high incidence of permanent severe neurological deficit, but usually the spine remains mechanically stable. Most of the management revolves around the associated injuries and consequences of the neurological deficit.

Cervical Vertebrae↗
PubMed2006

Microendoscopic discectomy for prolapsed lumbar intervertebral disc.

BACKGROUND: Lumbar disc prolapse is a common problem and the current surgical standard for its treatment is a microsurgical discectomy. Microendoscopic discectomy (MED) is a minimally invasive spinal procedure being done successfully for prolapsed intervertebral disc disease. AIMS: We report the technique, outcome and complications seen in 107 cases of prolapsed lumbar intervertebral disc who underwent MED. SETTING AND DESIGN: The study was carried out at the Department of Neurosurgery, at a tertiary hospital in South India and the data was collected prospectively. MATERIALS AND METHODS: 107 patients with prolapsed lumbar intervertebral disc who were seen at our institution between November 2002 and January 2006 were included in the study. Data was collected prospectively. The METRx system (Medtronic Sofamor Danek, Memphis,TN) was used to perform MED. Outcome assessment was done by the modified Macnab criteria. RESULTS: 107 patients (67 males, 40 females) underwent MED for prolapsed lumbar intervertebral disc. Follow up ranged from 2 to 40 months with a mean follow up 12.9 months. Seventy six patients had an excellent outcome, 22 patients had a good outcome, 5 patients had a fair outcome and 3 patients had a poor outcome. One patient with a long dural tear required conversion to a standard microdiscectomy and was excluded from outcome assessment. Complications included dural puncture with K-wire (1), dural tear (2), superficial wound infection (1), discitis (1) and recurrent disc prolapse (2). CONCLUSIONS: Microendoscopic Discectomy (MED) is a safe and effective procedure for the treatment of prolapsed lumbar intervertebral disc.

Adolescent↗
PubMed2004

Candida spondylodiscitis: an unusual case of thoracolumbar pain with review of imaging findings and description of the clinical condition.

Spondylodiscitis is an unusual but important cause of back pain. Patients with spinal infections typically present with severe sharp aching pain, malaise, fever, and percussion tenderness over the affected area. Early identification of the responsible organism is essential for adequate and prompt treatment. Fungal spondylodiscitis is extremely rare, and its presentation is insidious in nature. It uncommonly presents with fever or malaise. Clinically, the most reliable physical findings are paravertebral tenderness to palpation and an elevated erythrocyte sedimentation rate. Magnetic resonance imaging is crucial in diagnosing the condition, allowing for early medical intervention. A case of discitis with adjacent vertebral osteomyelitis (spondylodiscitis) of the thoracic spine due to Candida tropicalis is presented. One of the unusual aspects of this case is that the patient was not immunocompromised.

Journal Article↗
PubMed2004

Paradiscal extraforaminal technique for lumbar sympathetic block: report of a proposed new technique utilizing a cadaver study.

Knowledge of the relationship of the lumbar sympathetic chain to the vertebral bodies is needed to perform sympathetic block and sympatholysis. This information should be correlated with fluoroscopy to determine the best method to perform this technique clinically. Twenty cadavers were dissected to demonstrate the lumbar sympathetic chain. In five cadavers, a 17 G Hustead needle was introduced inferior to the transverse process in the concavity of the body of L2 vertebra utilizing an extraforaminal (paraforaminal) approach and images were obtained in both the anteroposterior and lateral views. Needles were placed by utilizing either the loss of resistance technique (just piercing the psoas muscle) or by placing the needle posterior to the anterior border of the vertebral body. The cadavers were then dissected to demonstrate needle position in relationship to the lumbar sympathetic chain. Each lumbar sympathetic chain was located on the anterolateral aspect of the vertebral body at the medial attachment of psoas major to the vertebral body. When needles were inserted using the loss of resistance technique, dissection revealed needle tips considerably anterior to the ganglia and missing it. When the needle was placed just on the anterior border of the vertebral body, the tip was close to the sympathetic chain. In all of the dissections, lumbar segmental vessels were found in the concavity of the vertebral body ventrodorsally and closely related to the sympathetic chain. The chain varies in both size and location of the ganglia. In the majority of cases, lumbar ganglia were 3 in number. We believe the extraforaminal technique of lumbar sympathetic block is superior to the paramedian approach considering that there should be a reduced chance of passing through viscera and a lower incidence of genitofemoral neuralgia. However, with the extraforaminal technique, two important possible complications need to be highlighted. Chances of injury to the segmental lumbar vessels and the anterior ramus are present. Therefore, the extraforaminal technique needs to be modified. We advocate the extraforaminal paradiscal technique for lumbar sympathetic block. The initial target point for entry should be the lateralmost tip of the transverse process. Advancement of the needle should be extraforaminal with minimal chance of injury to the nerve or the anterior ramus. Final target point should be paradiscal. The needle tip should be positioned just posterior to the anterior border of the vertebral body. Loss of resistance technique should not be utilized and is potentially dangerous. Use of at least two needles is advisable (L2 and L3 vertebral body). Care should be taken to avoid the lumbar vessels. A transdiscal technique recently advocated may also avoid some of the complications with the paramedian technique, but chances of discitis, nerve root injury, accelerated disc degeneration, disc herniation and rupture of the anterior annulus have to be considered when using this technique.

Journal Article↗
PubMed2004

Intrathecal cefazolin-induced seizures following attempted discography.

This report describes a 39 year-old woman who underwent attempted discography and intradiscal electrothermal therapy (IDET) of the L5/S1 intervertebral disc. The procedure was abandoned after multiple unsuccessful attempts to cannulate the disc. The case was complicated by at least two lumbar dural punctures, confirmed by injection of nonionic contrast that contained 12.5 mg/mL of cefazolin, included for prophylaxis of discitis. About 45 minutes later the patient developed severe back pain. Shortly thereafter she became progressively agitated and confused, and developed intractable seizures and coma. Despite aggressive treatment the patient could not be resuscitated and expired several hours later. Convulsions were initially attributed to an adverse reaction to meperidine and promethazine, given for the back pain, however this explanation proved to be untenable. In addition, the accidental administration of an ionic contrast agent, such as Hypaque(R), was excluded. Based on a detailed review of the case and the literature, it was concluded that the patient succumbed from an unintentional dose of intrathecal cefazolin, which had been diluted in the nonionic contrast agent that was used to confirm needle placement. Available evidence indicates that cefazolin is a potent epileptogenic agent when given intrathecally. The facts of the case and the evidence supporting the conclusion are presented. It is recommended that cefazolin not be mixed with the contrast agent used to document initial needle placement during discography.

Journal Article↗
PubMed1998

Minimally invasive techniques in spinal surgery: current practice.

Minimally invasive spinal surgery under arthroscopic or endoscopic magnification and illumination is emerging as an alternative, reliable method of treatment in a variety of spinal disorders. The operative techniques being used for discectomy and retrieval of herniated disc fragments or stabilization of unstable spinal motion segments are being utilized for visual diagnosis and debridement of infectious discitis and osteomyelitis transpedicular and transforaminal vertebral body biopsy, temporary diagnostic fixation of unstable lumbar motion segments, and transforaminal epidural steroid therapy.

Journal Article↗
PubMed1991

Anterior perforations in lumbar discectomies. A report of four cases of vascular complications and a CT study of the prevertebral lumbar anatomy.

Four cases of vascular complications to anterior perforations during discectomy prompted a CT study to measure lumbar disc diameters and to evaluate the prevertebral anatomy. Fifty young adults who had been referred for low-back pain and/or sciatica but had not undergone operation were included. In five additional patients, prone versus supine CT examinations were compared. Six typical configurations of the vascular anatomy could be classified to explain the type of vascular complications occurring at the L3-4 and L4-L5 disc levels. The sagittal diameter of the three lowest lumbar discs varied from 33 to 56 mm, indicating the importance of this parameter as an intraoperative guideline for the spine surgeon. Air-filled intestines were observed anterior to the L5-S1 disc predominantly in the prone position. The possible relationship between this finding and postoperative discitis is discussed.

Adult↗
PubMedDate not supplied

Evaluation of acute gait abnormalities in preschool children.

The charts of 60 consecutive children aged less than 5 years hospitalized for evaluation of a new onset limp or refusal to bear weight were reviewed. Only 1 of 22 patients with a normal complete blood count (CBC), erythrocyte sedimentation rate (ESR), and temperature had an infection. Of the 14 patients with a diagnosis of infection, only one had a normal CBC, ESR, and temperature. Radiographs were diagnostic in only four cases, whereas aspiration identified nine of 13 infections. Thirty-five bone scans were performed; 18 led to a definitive diagnosis including synovitis osteomyelitis, Perthes disease, juvenile rheumatoid arthritis, (JRA), fracture, soft tissue infection, and discitis.

Child, Preschool↗
PubMed1990

Automated percutaneous discectomy: a prospective multi-institutional study.

A prospective multi-institutional study was carried out to evaluate automated percutaneous discectomy in the treatment of lumbar disc herniations. Of the 327 patients who prospectively met the study criteria and were followed for longer than 1 year, 75.2% were successfully treated. When patients (n = 168) who prospectively did not meet the study criteria were treated, the success rate was 49.4%. One case of discitis was reported; otherwise, no other serious complications were noted, and specifically no vascular or nerve damage was encountered. This study indicates that automated percutaneous discectomy can be used successfully to treat lumbar disc herniations with minimal morbidity and emphasizes the need for proper patient selection.

Humans↗
PubMed1989

[Idiopathic benign non-infectious segmental vertebral sclerosis].

Idiopathic, benign, non-infectious, segmental, vertebral sclerosis is a self-limiting condition, which must be differentiated primarily from infectious spondylo-discitis and sclerosing vertebral metastases. The typical patient is a middle-aged, parous women with pain in the lower back region. Radiologically there is a characteristic half-dome shaped supradiscal sclerosis in the anterior and middle part of the affected vertebral body, which is always of normal height and there is never an abnormal paravertebral soft tissue mass. The erythrocyte sedimentation rate is normal. It is important to recognize this condition in order to avoid unnecessary examinations.

Adult↗
PubMed1989

Percutaneous lumbar discectomy. Review of 100 patients and current practice.

In a prospective study, 100 patients with 102 herniations of the nucleus pulposus at L2-L3, L3-L4, L4-L5, and L5-S1 and unremitting radicular pain were treated by percutaneous lumbar discectomy. Ninety-three patients were available for follow-up examination. Three patients had died, and four patients could not be located for this review, but all had been followed for more than one year postoperatively and were judged to have had an excellent result at the time of the last follow-up examination. Fifty-nine patients have been followed for longer than two years postoperatively, with a maximum follow-up period of six years. Evaluations were based on modified MacNab criteria and patient interview, questionnaire, and examination. Eighty-one patients (87%) were judged to be successes, since they were pain-free and had returned to gainful employment and their preinjury activity levels. Twelve patients' operations (13%) were judged to be failures and required repeat surgical procedures at the level of the presenting pathologic condition. Three patients (not included in the follow-up group) died of unrelated causes; they had been followed for a minimum of 15 months postoperatively and were previously judged to have had an excellent result. No major complications, including superficial or deep infections, discitis, or neurovascular compromise, were encountered. Meticulous selection of patients for percutaneous lumbar discectomy is the key to success with the method.

Adult↗
PubMed1986

CT findings in the vertebral column in the radicular lumbosacral syndrome.

An analysis of the CT findings in 150 patients with the radicular lumbosacral syndrome showed that 98 of them (65.3%) were suffering from intervertebral disc prolapse or protrusion. In 44 of these patients the finding of a prolapsed disc was combined with major spondylarthrosis while 20 others had marked spondylarthrosis or spondylosis with no apparent disc prolapse. Other findings included metastatic destruction of the vertebra (4 cases), fractured vertebra (2 cases), osteoid osteoma (1 case), and discitis (1 case). Slight or major asymmetry was found in 94 per cent, and a high incidence (38.8%) of the atypical rotatable type of intervertebral articulation was noted. The high percentage seems to confirm the hypothesis, according to which the rotatable type of intervertebral union is one of the predisposing factors for the development of the radicular lumbosacral syndrome.

Adolescent↗
PubMed1988

[Disk hypodensity and disk herniation].

The authors report the case of a patient with a herniated lumbar disk and bacterial meningitis. CT scan showed central disk hypodensity at the hernia level, whilst full cytological and bacteriological study of the disk following surgery revealed no evidence of spondylodiscitis. The problem was thus that of consequences of "degenerative" events related to the herniation. Central or peripheral disk hypodensity must in no case be considered as specific of discitis when there is a concomitant disk herniation.

Aged↗