Study Design: Case series.

Objective: To improve the isolation rate for pyogenic spondylodiscitis, we developed a new needle biopsy technique.

Summary Of Background Data: The biggest problem in treating lumbar pyogenic spondylodiscitis is a low success rate in isolating a causative microorganism. The rates have been reported 42% to 64%.

Methods: There are 3 steps: (A) Insert a 21-G needle as for discography, aspirate pus or fluid as specimen. (B) If step A fails, inject saline and collect fluid as reflux. (C) If step B fails, insert another needle into the disc, inject saline and collect reflux from the other needle. We applied this approach to 12 patients with a mean age of 64.3 years.

Results: We were able to collect fluid samples in all cases and the culture was positive in 11 cases (91.6%). Staphylococcus aureus was the most frequently identified organism (41.7%).

Conclusion: This simple method improved the isolation rate and should improve the treatment of lumbar pyogenic spondylodiscitis.

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http://dx.doi.org/10.1097/BRS.0b013e3181e8ad38DOI Listing

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