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Discitis Following Transdiscal Approach for Superior Hypogastric Plexus Block

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Challenging Cases and Complication Management in Pain Medicine

Abstract

Discitis—the infection of the intervertebral disc space—can result from hematogenous dissemination, direct disc inoculation (either iatrogenic or traumatic), or contiguous spread from an adjacent structure. Unless there is a chronological relationship between symptom onset and recent spine intervention or injury, the diagnosis may be delayed for weeks or months. The initial symptoms are often non-specific (severe back pain, stiffness, occasional fever, and malaise) with evidence of elevated inflammatory markers on work-up. Once discitis is suspected, imaging studies (contrast MRI, PET, or CT scan) should be immediately obtained. Image-guided aspiration biopsy is performed when blood cultures or serologic tests fail to identify the responsible pathogen. Conservative treatment with intravenous antibiotics should be guided by microbiology results. If general or neurologic deterioration occurs, empiric antimicrobial therapy should be initiated and surgery should be considered (Berbari et al., Clin Infect Dis. 61(6):e26–46, 2015).

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Author information

Authors and Affiliations

  1. NYU School of Medicine, Dept. of Anesthesiology, Perioperative Care and Pain Medicine, New York, NY, USA

    Lucia Daiana Voiculescu M.D. & Qian CeCe Chen M.D.

Authors
  1. Lucia Daiana Voiculescu M.D.
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  2. Qian CeCe Chen M.D.
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Corresponding author

Correspondence to Lucia Daiana Voiculescu M.D. .

Editor information

Editors and Affiliations

  1. Department of Anesthesia and Critical Care, University of Chicago Medicine, Chicago, Illinois, USA

    Magdalena Anitescu

  2. Department of Anesthesiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA

    Honorio T. Benzon

  3. Division of Pain Medicine, Department of Anesthesiology, University of California San Diego School of Medicine, La Jolla, California, USA

    Mark S. Wallace

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Voiculescu, L.D., Chen, Q.C. (2018). Discitis Following Transdiscal Approach for Superior Hypogastric Plexus Block. In: Anitescu, M., Benzon, H., Wallace, M. (eds) Challenging Cases and Complication Management in Pain Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-60072-7_26

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  • DOI: https://doi.org/10.1007/978-3-319-60072-7_26

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60070-3

  • Online ISBN: 978-3-319-60072-7

  • eBook Packages: MedicineMedicine (R0)

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