CardioVascular and Interventional Radiology

, Volume 40, Issue 1, pp 125–129 | Cite as

CT Fluoroscopy-Guided Transsacral Intervertebral Drainage for Pyogenic Spondylodiscitis at the Lumbosacral Junction

  • Tomohiro Matsumoto
  • Takahiko Mine
  • Toshihiko Hayashi
  • Masahiro Kamono
  • Akiko Taoda
  • Megumu Higaki
  • Terumitsu HasebeEmail author
Technical Note



To retrospectively describe the feasibility and efficacy of CT fluoroscopy-guided transsacral intervertebral drainage for pyogenic spondylodiscitis at the lumbosacral junction with a combination of two interventional radiological techniques—CT-guided bone biopsy and abscess drainage.

Materials and methods

Three patients with pyogenic spondylodiscitis at the lumbosacral junction were enrolled in this study between July 2013 and December 2015. The procedure of CT fluoroscopy-guided transsacral intervertebral drainage for pyogenic spondylodiscitis at the lumbosacral junction was as follows: the sacrum at S1 pedicle was penetrated with an 11-gauge (G) bone biopsy needle to create a path for an 8-French (F) pigtail drainage catheter. The bone biopsy needle was withdrawn, and an 18-G needle was inserted into the intervertebral space of the lumbosacral junction. Then, a 0.038-inch guidewire was inserted into the intervertebral space. Finally, the 8-F pigtail drainage catheter was inserted over the guidewire until its tip reached the intervertebral space. All patients received six-week antibiotics treatment.


Successful placement of the drainage catheter was achieved for each patient without procedural complications. The duration of drainage was 17–33 days. For two patients, specific organisms were isolated; thus, definitive medical therapy was possible. All patients responded well to the treatment.


CT fluoroscopy-guided transsacral intervertebral drainage for pyogenic spondylodiscitis at the lumbosacral junction is feasible and can be effective with a combination of two interventional techniques—CT fluoroscopy-guided bone biopsy and abscess drainage.


CT fluoroscopy-guided drainage Pyogenic spondylodiscitis Interventional radiology Lumbosacral junction 



We would like to thank Prof. Tetsuya Suzuki, Prof. Atsushi Hotta, and their students of the Department of Mechanical Engineering, Keio University, for their help in the creation of some of the figures; Dr. Yusuke Kabeya and Dr. Eiseki Sohara of the Department of General Internal Medicine, Tokai University Hachioji Hospital, for their help in patient management; and Dr. Kazunobu Hashida, Dr. Kosuke Tomita, and Dr. Satoshi Suda of the Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, for continuing support and encouragement.

Compliance with Ethical Standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Supplementary material 1 (WMV 1537 kb)


  1. 1.
    Acosta FL Jr, Galvez LF, Aryan HE, Ames CP. Recent advances: infections of the spine. Curr Infect Dis Rep. 2006;8(5):390–3.CrossRefPubMedGoogle Scholar
  2. 2.
    Grados F, Lescure FX, Senneville E, Flipo RM, Schmit JL, Fardellone P. Suggestions for managing pyogenic (non-tuberculous) discitis in adults. Jt Bone Spine. 2007;74(2):133–9.CrossRefGoogle Scholar
  3. 3.
    Staatz G, Adam GB, Keulers P, Vorwerk D, Gunther RW. Spondylodiskitic abscesses: CT-guided percutaneous catheter drainage. Radiology. 1998;208(2):363–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Matsumoto T, Yamagami T, Morishita H, Iida S, Asai S, Masui K, et al. CT-guided percutaneous drainage within intervertebral space for pyogenic spondylodiscitis with psoas abscess. Acta Radiol. 2012;53(1):76–80.CrossRefPubMedGoogle Scholar
  5. 5.
    Griffiths HE, Jones DM. Pyogenic infection of the spine. A review of twenty-eight cases. J Bone Jt Surg Br. 1971;53(3):383–91.Google Scholar
  6. 6.
    Tofuku K, Koga H, Komiya S. Percutaneous drainage combined with hyperbaric oxygen therapy for pyogenic spondylitis with iliopsoas abscess. Asian Spine J. 2014;8(3):253–9.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Daly B, Templeton PA. Real-time CT fluoroscopy: evolution of an interventional tool. Radiology. 1999;211(2):309–15.CrossRefPubMedGoogle Scholar
  8. 8.
    Kato T, Yamagami T, Iida S, Tanaka O, Hirota T, Nishimura T. Percutaneous drainage under real-time computed tomography-fluoroscopy guidance. Hepatogastroenterology. 2005;52(64):1048–52.PubMedGoogle Scholar
  9. 9.
    Yamagami T, Terayama K, Yoshimatsu R, Matsumoto T, Miura H, Nishimura T. Percutaneous drainage of psoas abscess under real-time computed tomography fluoroscopic guidance. Skelet Radiol. 2009;38(3):275–80.CrossRefGoogle Scholar
  10. 10.
    Jeanneret B, Magerl F. Treatment of osteomyelitis of the spine using percutaneous suction/irrigation and percutaneous external spinal fixation. J Spinal Disord. 1994;7(3):185–205.CrossRefPubMedGoogle Scholar
  11. 11.
    Gervais DA, Brown SD, Connolly SA, Brec SL, Harisinghani MG, Mueller PR. Percutaneous imaging-guided abdominal and pelvic abscess drainage in children. Radiographics. 2004;24(3):737–54.CrossRefPubMedGoogle Scholar
  12. 12.
    McHenry MC, Easley KA, Locker GA. Vertebral osteomyelitis: long-term outcome for 253 patients from 7 Cleveland-area hospitals. Clin Infect Dis. 2002;34(10):1342–50.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2016

Authors and Affiliations

  • Tomohiro Matsumoto
    • 1
  • Takahiko Mine
    • 1
  • Toshihiko Hayashi
    • 1
  • Masahiro Kamono
    • 2
  • Akiko Taoda
    • 2
  • Megumu Higaki
    • 2
  • Terumitsu Hasebe
    • 1
    Email author
  1. 1.Department of Radiology, Tokai University Hachioji HospitalTokai University School of MedicineHachiojiJapan
  2. 2.Department of General Internal Medicine, Tokai University Hachioji HospitalTokai University School of MedicineHachiojiJapan

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