Percutaneous transpedicular management of discitis

Satyendra Arya, Wayne N. Crow, Alexander G. Hadjipavlou, Haring J W Nauta, Adam M. Borowski, Lawrence A. Vierra, Eric Walser

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

PURPOSE: To present the technique of percutaneous transpedicular biopsy and debridement of discs in diagnosis and management of discitis. MATERIALS AND METHODS: Fifteen patients underwent disc biopsy through a transpedicular approach with local anesthesia and fluoroscopic guidance. An attempt was made to debride the disc as much as possible. A surgical vacuum drain was deployed through the transpedicular tract when there was persistent drainage. RESULTS: Fifteen patients underwent percutaneous transpedicular disc biopsy and debridement of disc for suspected discitis. Three patients underwent biopsy only and 12 underwent percutaneous discectomy. Six patients had at least one positive culture. Eight patients who underwent discectomy had immediate improvement of pain or neurologic symptoms, obviating emergency surgical debridement of the disc. Four patients did not improve and underwent surgical debridement and fusion. CONCLUSIONS: Transpedicular biopsy of the disc is an effective technique for adequate tissue retrieval and diagnosis of discitis. Adequate debridement in selected patients with antibiotic therapy may be definitive. Epidural extension of discitis and massive vertebral destruction precludes percutaneous treatment.

Original languageEnglish (US)
Pages (from-to)921-927
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume7
Issue number6
StatePublished - 1996

Fingerprint

Discitis
Debridement
Biopsy
Percutaneous Diskectomy
Diskectomy
Local Anesthesia
Vacuum
Neurologic Manifestations
Drainage
Emergencies
Anti-Bacterial Agents
Pain
Therapeutics

Keywords

  • Spine, biopsy, 326.1261, 336.1261
  • Spine, infection, 326.25, 336.25
  • Spine, intervertebral disks, 326.1261, 336.1261

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Arya, S., Crow, W. N., Hadjipavlou, A. G., Nauta, H. J. W., Borowski, A. M., Vierra, L. A., & Walser, E. (1996). Percutaneous transpedicular management of discitis. Journal of Vascular and Interventional Radiology, 7(6), 921-927.

Percutaneous transpedicular management of discitis. / Arya, Satyendra; Crow, Wayne N.; Hadjipavlou, Alexander G.; Nauta, Haring J W; Borowski, Adam M.; Vierra, Lawrence A.; Walser, Eric.

In: Journal of Vascular and Interventional Radiology, Vol. 7, No. 6, 1996, p. 921-927.

Research output: Contribution to journalArticle

Arya, S, Crow, WN, Hadjipavlou, AG, Nauta, HJW, Borowski, AM, Vierra, LA & Walser, E 1996, 'Percutaneous transpedicular management of discitis', Journal of Vascular and Interventional Radiology, vol. 7, no. 6, pp. 921-927.
Arya S, Crow WN, Hadjipavlou AG, Nauta HJW, Borowski AM, Vierra LA et al. Percutaneous transpedicular management of discitis. Journal of Vascular and Interventional Radiology. 1996;7(6):921-927.
Arya, Satyendra ; Crow, Wayne N. ; Hadjipavlou, Alexander G. ; Nauta, Haring J W ; Borowski, Adam M. ; Vierra, Lawrence A. ; Walser, Eric. / Percutaneous transpedicular management of discitis. In: Journal of Vascular and Interventional Radiology. 1996 ; Vol. 7, No. 6. pp. 921-927.
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AB - PURPOSE: To present the technique of percutaneous transpedicular biopsy and debridement of discs in diagnosis and management of discitis. MATERIALS AND METHODS: Fifteen patients underwent disc biopsy through a transpedicular approach with local anesthesia and fluoroscopic guidance. An attempt was made to debride the disc as much as possible. A surgical vacuum drain was deployed through the transpedicular tract when there was persistent drainage. RESULTS: Fifteen patients underwent percutaneous transpedicular disc biopsy and debridement of disc for suspected discitis. Three patients underwent biopsy only and 12 underwent percutaneous discectomy. Six patients had at least one positive culture. Eight patients who underwent discectomy had immediate improvement of pain or neurologic symptoms, obviating emergency surgical debridement of the disc. Four patients did not improve and underwent surgical debridement and fusion. CONCLUSIONS: Transpedicular biopsy of the disc is an effective technique for adequate tissue retrieval and diagnosis of discitis. Adequate debridement in selected patients with antibiotic therapy may be definitive. Epidural extension of discitis and massive vertebral destruction precludes percutaneous treatment.

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