Postoperative discitis after instrumentation and interbody fusion [Neurosurgery Wiki]

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====== Postoperative discitis after instrumentation and interbody fusion ======

In the Carmouche series 
((Carmouche JJ, Molinari RW. Epidural abscess and discitis complicating instrumented posterior lumbar interbody fusion: a case report. Spine (Phila Pa 1976). 2004 Dec 1;29(23):E542-6. doi: 10.1097/01.brs.0000146802.38753.38. PMID: 15564903.))
of [[postoperative discitis]] after [[instrumentation]] and [[interbody fusion]] with an [[epidural abscess]], the patient underwent two procedures to eradicate the [[infection]], the first was surgical [[debridement]] and [[epidural abscess]] drainage and because of the worsening clinical symptoms, underwent repeat debridement and the removal of his [[interbody cage]] and [[pedicle screw]] [[instrumentation]] four months after index surgery. At ten-month follow-up, the posterolateral [[arthrodesis]] was healed and his [[back pain]] had improved compared to preoperative levels.
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Kulkarni et al. 
((Kulkarni AG, Hee HT. Adjacent level discitis after anterior cervical discectomy and fusion (ACDF): a case report. Eur Spine J. 2006 Oct;15 Suppl 5(Suppl 5):559-63. doi: 10.1007/s00586-005-0003-x. Epub 2005 Dec 7. PMID: 16333681; PMCID: PMC1602186.))
reported a case of [[adjacent level]] discitis after [[anterior cervical discectomy and fusion]]. The patient underwent surgical treatment with debridement, irrigation, and removal of hardware, and reconstruction of infected level by tricortical iliac crest autograft; the cages were left intact. He had IV antibiotic treatment for three weeks and oral medication for three weeks. The neurological recovery was complete and at eight-month-follow-up the fusions were sound.