La infección del interespacio representa una complicación poco habitual tras la cirugía de la hernia de disco lumbar.
Se analiza la presentación clínica y radiológica en 6 casos de discitis postquirúrgica que representan el 0,8% de los pacientes intervenidos en nuestro servicio de hernia de disco lumbar.
Todos los casos presentaron dolor lumbar acompañado de fiebre, elevación significativa de la velocidad de sedimentación globular y en el estudio con resonancia magnética se evidenció la presencia de hiposeñal en T1 e hiperseñal en T2 a nivel de los platillos, y realce con gadolinio.
Se realizó tratamiento con reposo, antiestafilocócicos e inmovilización lumbar.
Tras una revisión de la literatura, se recalca la importancia de las determinaciones analíticas postoperatorias cuando se sospecha la presencia de discitis, siendo imprescindible a nuestro entender practicar una resonancia magnética sin y con contraste para poder hacer un diagnóstico preciso.
Discitis is an infrequent complication after intervertebral disc surgery. We review a series of 6 cases of postoperative discitis who represent 0.8% of all the patients operated on for lumbar disc herniation.
All the patients had low back pain, fever and an increased postoperative erytrocite sedimentation rate (ESR). Magnetic resonance imaging with and without administration of gadolinium showed decreased bone marrow signal intensity adjacent to the disk space on the T1-weighted image and increased disk space signal intensity on the more T2-weighted image.
Treatment was performed with bed rest, antimicrobial therapy and inmobilization of the spine.
The authors suggest that increased body temperature, and ESR within few days after disc operation is the first sign of infection. This should be confirmed with MRI unenhnaced and enhanced T1 and T2 sequences.
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