Summary
In 412 patients undergoing surgery for herniated lumbar discs from September 1986 to September 1987 and from January 1988 to July 1989 a microbiological specimen was taken from the intervertebral disc space and from the cover of the operating microscope. Also the tips of the wound drains were examined microbiologically after removal. 17% of the patients had a positive bacteriological culture from their intervertebral disc space; 12% of the specimen from the operating microscope were positive. These results favour the hypothesis that intra-operative contamination of the disc space, in contrast to haematogeneous spread, causes spondylodiscitis. On the other hand we saw during this time course only one case of clinical spondylodiscitis, which implies a possible involvement of other predisposing factors such as pre- or perioperative infections or compromised patient immunologically. It is also possible, that the routine application of local antibiotic or antiseptic solutions into the disc space at the end of the operation could decontaminate the operative site and prevent clinical infection despite positive culture findings.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Batson OV (1940) Function of vertebral veins and their role in spread of metastasis. Ann Surg 112: 138–149
Brant-Zawadski M, Burke VD, Joffrey RB (1983) CT in the evaluation of spine infection. Spine 8(4): 358–364
Busse O, Stolke D, Seidel BU (1976) Die postoperative Discitis intervertebralis lumbalis. Nervenarzt 47: 604–608
Coventry MB, Ghomerley RK, Kernohan JW (1945) The intervertebral disc: it's microscopic anatomy and pathology, Part II. J Bone Joint Surg 27(A): 233–247
Craig FS (1956) Vertebral body biopsy. J Bone Joint Surg 38(A): 93–102
Dauch WA (1986) Infection of the intervertebral space following conventional and microsurgical operation on the herniated lumbar intervertebral disc. Acta Neurochir (Wien) 82: 43–49
De Souza LJ (1980) Disc space infection in children, late adolescents, and adults. Minn Med 63: 314–320
Ebeling U, Reulen H-J (1983) Ergebnisse der mikrochirurgischen Bandscheibenoperation. Neurochirurgia 26: 12–17
Green JR, Kanshepolsky J, Turkian B (1974) Incidence and significance of central nervous system infection in neurosurgical patients. Adv Neurol 6: 223–228
Kemp HBS, Jackson JW, Jeremiah JD, Hall AJ (1973) Pyogenic infections occurring primarily in intervertebral discs. J Bone Joint Surg 55(B): 698–714
Littleton HR, Rhoades ER (1980) Septic discitis: report of case and review of the literature. J Am Osteopath Assoc 79(8): 544–546
Oldenkott P (1988) Vertebragene Radikulopathien und Pseudoradikulopathien. In: Delank H-W, Schmitt E (eds) Die Wirbelsäule in Forschung und Praxis, Bd 108. Hippokrates Verlag, Stuttgart, pp 81–86
Onofrio B (1980) Intervertebral discitis, Incidence, Diagnosis, and Management. In: Clinical neurosurgery. Proceedings of the Congress of Neurological Surgeons, Las Vegas 1979. Williams and Wilkins, Baltimore London
Ottolenghi CA (1955) Diagnosis of orthopedic lesions by aspiration biopsy. J Bone Joint Surg 37(A): 443–464
Pilgaard S (1969) Discitis following removal of lumbar intervertebral discs. J Bone Joint Surg 51(A): 713–716
Puranen J, Mäkelä J, Lähde S (1984) Postoperative intervertebral discitis. Acta Orthop Scand 55: 461–465
Rawlings CE, Wilkins RH, Gallis HA, Goldner JL, Francis R (1983) Postoperative intervertebral disc space infection. Neurosurgery 13(4): 371–376
Schepelmann F, Greiner L, Pia H-W (1977) Complications following operation of the herniated lumbar disc. In: Wüllenweber Ret al (eds) Advances in neurosurgery, Vol 4. Springer, Berlin Heidelberg New York, pp52–54
Scherbel AL, Garnder JW (1960) Infections involving the intervertebral disc. JAMA 24: 108–112
Schultz EC (1958) Postoperative bone changes following lumbar disc removal. J Neurosurg 15: 537–547
Seifert V, Stolke D, Vogelsang HG (1983) Die postoperative Discitis intervertebralis lumbalis. Akt Neurol 10: 161–166
Stolke D, Seifert V, Kunz U (1988) Die postoperative Discitis intervertebralis lumbalis. Eine Übersicht über einen 15-Jahres-Zeitraum und 7493 Operationen. Z Orthop 126: 666–670
Thibodeau AA (1968) Closed space infections following removal of lumbar intervertebral disc. J Bone Joint Surg 60(A): 400–410
Ullmann U (1986) Bakterielle Infektionen bei hospitalisierten Patienten. Zbl Bakt Hyg B 183: 103–113
Wenger DR, Bobechko WP, Gilday DL (1978) The spectrum of intervertebral disc space infection in children. J Bone Joint Surg 60(A): 100–108
Williams RW (1978) Microlumbar discectomy, a conservative surgical approach to the virgin herniated lumbar disc. Spine 3: 175–182
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tronnier, V., Schneider, R., Kunz, U. et al. Postoperative spondylodiscitis: Results of a prospective study about the aetiology of spondylodiscitis after operation for lumbar disc herniation. Acta neurochir 117, 149–152 (1992). https://doi.org/10.1007/BF01400612
Issue Date:
DOI: https://doi.org/10.1007/BF01400612