Therapy of lumbar discitis utilizing silicon nitride spinal spacers: A case sequence and literature assessment.
Int J Surg Case Rep. 2018 Feb 10;43:61-68
Authors: Rambo WM
Summary
INTRODUCTION: Septic an infection of a lumbar intervertebral disc is a critical dysfunction which is usually tough to diagnose and appropriately deal with due to the rarity of the illness, the numerous presentation of signs, and the frequency of low-back ache throughout the general inhabitants. Its etiology could be pyogenic, granulomatous, fungal, or parasitic; its incidence is rising resulting from elevated affected person susceptibility and improved diagnostic instruments. Conservative remedies contain antibiotics, bodily remedy, and/or immobilization. Extra aggressive administration requires discectomy, debridement, and spinal fusion together with native and systemic antibiotic administration.
PRESENTATION OF CASES: Offered listed below are two case research of lumbar pyogenic discitis related to Escherichia coli and Candida albicans infections. Each required single-level anterior discectomy adopted by spinal fusion utilizing an antimicrobial silicon nitride (Si3N4) spacer for stabilization with out instrumentation. Localized antibiotics had been used for less than one of many sufferers. Observe-up CT and MRI scans confirmed that the infections had been resolved with no recurrence of signs.
DISCUSSION: Si3N4 is a comparatively new spinal spacer materials. It was utilized in these two circumstances as a result of it reportedly offers a neighborhood setting which promotes fast arthrodesis whereas resisting bacterial adhesion and biofilm formation. It is usually extremely appropriate with X-ray, MRI, and CT imaging modalities. These properties had been significantly engaging for these two circumstances given the sufferers’ histories, presentation of signs, and the choice to forego instrumentation.
CONCLUSION: The usage of Si3N4 as an antimicrobial spacer might result in improved outcomes for sufferers with pyogenic discitis of the lumbar backbone.
PMID: 29462728 [PubMed – as supplied by publisher]