Fluoroscopy-Guided Percutaneous Transpedicular Biopsy Versus Posterolateral Endoscopy for Infective Spondylodiskitis Diagnosis: A Comparative Study.

Objective: We sought to determine the concordance in frequency of microbiologic isolation and species identification in specimens obtained by 2 methods.

Methods: Intervertebral disk specimens were taken simultaneously from each patient using percutaneous needle and posterolateral endoscopic biopsies. The isolates were reported in frequencies and concordance using the chi square and Cohen kappa tests.

Results: Thirty patients were recruited. The average age was 58.1 years, and 15 patients were women. The clinical evolution time was 7 ± 4 months. The causative organism was identified in 12 (40%) specimens obtained by fluoroscopy-guided percutaneous transpedicular biopsy and in 14 (46.6%) obtained by posterolateral endoscopy. The most common organism isolated was Staphylococcus aureus in 3 patients with the percutaneous technique and in 5 with the endoscopic one; Escherichia coli was isolated in 3 patients with each method. The kappa test showed a high degree of agreement between both methods (kappa = 0.86); the agreement in bacterial species identification was 100%.

Conclusions: Fluoroscopy-guided percutaneous biopsy and endoscopic sampling have a good degree of concordance for both, frequency of organism isolation and identification in patients with infectious spondylodiskitis.