Spine Surgery pp 339-344 | Cite as

Pyogenic Infection Following Single Level Nucleotomy

  • Andrei Slavici


Postprocedural infections of the spine are a dreaded complication putting great strain on both patients and surgeons alike. While the incidence of postoperative discitis in spine surgeries without instrumentation is often cited up to 4%, approx. 480.000 nucleotomies are performed yearly in the United States alone [1, 2]. These figures highlight the necessity for every spinal surgeon to be familiar with the diagnostics and management of postoperative infections. With the following case we will try to illustrate a typical case of postprocedural discitis managed with dorsal instrumentation and interbody fusion.


  1. 1.
    Gray DT, Deyo RA, Kreuter W, Mirza SK, Heagerty PJ, et al. Population-based trends in volumes and rates of ambulatory lumbar spine surgery. Spine (Phila Pa 1976). 2006;31:1957–63.CrossRefGoogle Scholar
  2. 2.
    Sherman J, Cauthen J, Schoenberg D, Burns M, Reaven NL, et al. Economic impact of improving outcomes of lumbar discectomy. Spine J Off J North Am Spine Soc. 2010;10:108–16.CrossRefGoogle Scholar
  3. 3.
    Kang B-U, Lee S-H, Ahn Y, Choi W-C, Choi Y-G. Surgical site infection in spinal surgery: detection and management based on serial C-reactive protein measurements. J Neurosurg Spine. 2010;13:158e164.CrossRefGoogle Scholar
  4. 4.
    Maus U, Anderega S, Gravius S, Ohnsorge JA, Miltner O. Procalcitonin (PCT) as a diagnostic tool for monitoring of spondylodiscitis. Z Orthop Unfall. 2009;147:59e64.CrossRefGoogle Scholar
  5. 5.
    Noh S, Zhang H, Lim H, Song H, Yang K. Decompression alone versus fusion for pyogenic spondylodiscitis. Spine J. 2017;17(8):1120–6. Scholar
  6. 6.
    Legrand E, Flipo R-M, Guggenbuhl P, et al. Management of non-tuberculous infectious discitis. Treatments used in 110 patients admitted to 12 teaching hospitals in France. Joint Bone Spine. 2001;68:504e509.Google Scholar
  7. 7.
    Roblot F, Besnier JM, Juhel L, et al. Optimal duration of antibiotic therapy in vertebral osteomyelitis. Semin Arthritis Rheum. 2007;36:269e277.CrossRefGoogle Scholar
  8. 8.
    Schomacher M, Finger T, Koeppen D, et al. Application of titanium and polyetheretherketone cages in the treatment of pyogenic spondylodiscitis. Clin Neurol Neurosur. 2014;127:65–70. Scholar
  9. 9.
    Shiban E, Janssen I, Wostrack M, et al. A retrospective study of 113 consecutive cases of surgically treated spondylodiscitis patients. A single-center experience. Acta Neurochir. 2014;156(6):1189–96. Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Andrei Slavici
    • 1
  1. 1.Department of Spine and Reconstructive Orthopedic SurgerySana Klinikum OffenbachOffenbach am MainGermany

Personalised recommendations