Management of post-operative discitis following discectomy in a tertiary-level hospital
Purpose: To perform retrospective analysis of 75 post-operative disc space infections after open lumbar discectomy (OLD) and to assess the outcome of their medical and surgical management in a tertiary-level hospital. Methods: Records of 50 men and 25 women aged 26–65 (mean, 42.53) years who underwe...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-02-01
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| Series: | Journal of Orthopaedic Surgery |
| Online Access: | https://doi.org/10.1177/2309499020988213 |
| _version_ | 1818447034120667136 |
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| author | Md Kamrul Ahsan Md Sariful Hasan Md Shahidul Islam Khan Najmus Sakeb |
| author_facet | Md Kamrul Ahsan Md Sariful Hasan Md Shahidul Islam Khan Najmus Sakeb |
| author_sort | Md Kamrul Ahsan |
| collection | DOAJ |
| description | Purpose: To perform retrospective analysis of 75 post-operative disc space infections after open lumbar discectomy (OLD) and to assess the outcome of their medical and surgical management in a tertiary-level hospital. Methods: Records of 50 men and 25 women aged 26–65 (mean, 42.53) years who underwent treatment for post-operative discitis (POD) after single level OLD at L3–4 (n = 8), L4–5 (n = 42), L5–S1 (n = 25) level. The POD was diagnosed according to specific clinical signs, laboratory and radiographic investigations and all of them received initial intravenous antibiotics (IVA) for at least 4–6 weeks followed by oral ones. Successful responders (n = 55) were considered in Group-C and remainder [Group-S (n = 20)] were operated at least after 4 weeks of failure. Demographic data, clinical variables, hospital stay, duration of antibiotic treatment and post-treatment complications were collected from the hospital record and assessment before and after treatment were done by using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score. Comprehensive outcome was evaluated by modified criteria of Kirkaldy-Willis. Results: The mean follows up was 36.38 months. Significant improvement of mean VAS and JOA score was achieved in both conservative (76.36% satisfactory) and operative (90% satisfactory) groups although the difference was statistically insignificant. Conclusion: Although insignificant, early surgical intervention provided better results (e.g. functional outcomes, length of hospital stay and duration of antibiotic treatment therapy) than conventional conservative treatment in post-operative discitis. |
| first_indexed | 2024-12-14T19:57:12Z |
| format | Article |
| id | doaj.art-73aec8c76cbd4652b1d6abc1274daad6 |
| institution | Directory Open Access Journal |
| issn | 2309-4990 |
| language | English |
| last_indexed | 2024-12-14T19:57:12Z |
| publishDate | 2021-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Orthopaedic Surgery |
| spelling | doaj.art-73aec8c76cbd4652b1d6abc1274daad62022-12-21T22:49:17ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902021-02-012910.1177/2309499020988213Management of post-operative discitis following discectomy in a tertiary-level hospitalMd Kamrul Ahsan0Md Sariful Hasan1Md Shahidul Islam Khan2Najmus Sakeb3 Department of Orthopaedic Surgery, , Dhaka, Bangladesh Department of Orthopaedic Surgery, , Dhaka, Bangladesh Department of Orthopaedic Surgery, , Dhaka, Bangladesh Department of Orthopaedic surgery, , Dhaka, BangladeshPurpose: To perform retrospective analysis of 75 post-operative disc space infections after open lumbar discectomy (OLD) and to assess the outcome of their medical and surgical management in a tertiary-level hospital. Methods: Records of 50 men and 25 women aged 26–65 (mean, 42.53) years who underwent treatment for post-operative discitis (POD) after single level OLD at L3–4 (n = 8), L4–5 (n = 42), L5–S1 (n = 25) level. The POD was diagnosed according to specific clinical signs, laboratory and radiographic investigations and all of them received initial intravenous antibiotics (IVA) for at least 4–6 weeks followed by oral ones. Successful responders (n = 55) were considered in Group-C and remainder [Group-S (n = 20)] were operated at least after 4 weeks of failure. Demographic data, clinical variables, hospital stay, duration of antibiotic treatment and post-treatment complications were collected from the hospital record and assessment before and after treatment were done by using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score. Comprehensive outcome was evaluated by modified criteria of Kirkaldy-Willis. Results: The mean follows up was 36.38 months. Significant improvement of mean VAS and JOA score was achieved in both conservative (76.36% satisfactory) and operative (90% satisfactory) groups although the difference was statistically insignificant. Conclusion: Although insignificant, early surgical intervention provided better results (e.g. functional outcomes, length of hospital stay and duration of antibiotic treatment therapy) than conventional conservative treatment in post-operative discitis.https://doi.org/10.1177/2309499020988213 |
| spellingShingle | Md Kamrul Ahsan Md Sariful Hasan Md Shahidul Islam Khan Najmus Sakeb Management of post-operative discitis following discectomy in a tertiary-level hospital Journal of Orthopaedic Surgery |
| title | Management of post-operative discitis following discectomy in a tertiary-level hospital |
| title_full | Management of post-operative discitis following discectomy in a tertiary-level hospital |
| title_fullStr | Management of post-operative discitis following discectomy in a tertiary-level hospital |
| title_full_unstemmed | Management of post-operative discitis following discectomy in a tertiary-level hospital |
| title_short | Management of post-operative discitis following discectomy in a tertiary-level hospital |
| title_sort | management of post operative discitis following discectomy in a tertiary level hospital |
| url | https://doi.org/10.1177/2309499020988213 |
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