THE RULE OF CT-GUIDED BIOPSY IN THE TREATMENT OF PYOGENIC SPONDOIYODISCITIS

Amjad AL Rashdan, MD*., Raed Al Khub, MD., Monther Alessa, MD., Faris Ababneh, MD., Ranaa ALkrimeen, MD., Maysoon Khlaif MD and Mohamad Zakaria, MD

ABSTRACT

Background: Spondylodiscitis represents 2%–4% of all bone infection cases. The correct diagnosis and appropriate treatment can prevent complications such as vertebral collapse and spinal cord compression, avoiding surgical procedures. The diagnosis is based on characteristic clinical and radiographic findings and confirmed by blood culture and biopsy of the disc or the vertebra. Pyogenic spondylitis commonly occurs in adults in their fifth decade, and males are affected twice as often as females. The vertebral body and intervertebral disc are commonly involved. Aim: To compare the clinical and radiological improvement of the patients who were treated with empirical antibiotics and patients who underwent CT-guided biopsies followed by antibiotics according to the culture obtained by CT guided method. Method: This retrospective study was conducted at King Hussein medical Centre in Amman, capital of Jordan, from January 2016 to July 2019. Forty-seven patients with provisional diagnosis of spondylodiscitis were classified into two groups, group A who have a positive finding of the CT-guided biopsy. Group B with no pathogen identified due to negative result of the procedure or not performing it. Laboratory, radiological and culture findings were evaluated and IV antibiotics were commenced either empirically or according to CT-guided culture for both groups. Conclusion: CT-guided percutaneous biopsy of the spine is effective, simple procedure to evaluate suspicious spine lesions both in the case of malignancy and infection with a high accuracy rate and low risk of complications. It is essential to plan subsequent management and treatment of the patients.

Keywords: Spondylodiscitis, CT-guided biopsy, Spine, Osteomyelitis.