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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2005 June;56(3):133-7
Postoperative spondylodiscitis: surgical treatment? Report of two cases.
Turtas S. 1, Paulis M. 2, Orunesu G. 2, Chessa M. A. 2
1 Clinica Neurochirurgica Università degli Studi di Sassari, Sassari
2 U.O. di Neurochirurgia Ospedale S. Francesco, Nuoro
Intervertebral disc space infection is an uncommon complication of disc surgery. Following a review of the pertinent literature, some features of the 2 reported cases are worthy to be stressed. They are: a) Clinical picture. The prevailing symptom is an excruciating sciatica rather than the more commonly reported back pain. This fact is likely justified by the peculiar morphology of the infective focus acting as a preforaminal disc prolapse. b) Magnetic resonance imaging findings. Characteristic morphological changes of the disc space and the surrounding structures are seen in our cases similarly to those described in the literature, except for the spinal canal involvement. According to the authors, the unusual extra-discal extension of the lesion seems justified by the surgical dissemination and the following organization of the infective focus. c) The early surgical treatment of the post-operative spondylodiscitis does not improve nor shorten the clinical course of this complication compared to that likely obtained with bed rest (or immobilization) and antibiotic therapy.