Site matters: Image-guided percutaneous sampling of intervertebral disc results in increased positive diagnostic yield in spondylodiscitis

Br J Neurosurg. 2023 Apr;37(2):177-181. doi: 10.1080/02688697.2021.2013438. Epub 2021 Dec 14.

Abstract

Spondylodiscitis is a common referral to spinal on call services. Identification of the causative organism is vital in order to dictate the appropriate antibiotic treatment. In this context, the surgical and interventional radiology team is often asked to perform a diagnostic biopsy. The aim of the present study was to assess whether the sampling location affects the diagnostic yield. Our results suggest that the overall positive diagnostic yield was 35%. When disc material was included in the sample the diagnostic yield significantly improved to 47%. Bone sampling alone had a positive yield of 15%. Age, pre-biopsy CRP, pre-biopsy use of antibiotics did not seem to affect the likelihood of obtaining a positive yield. These results suggests that when performing image guided biopsies for suspected cases of spondylodiscitis the inclusion of disc material is important.

Keywords: CRP: C-reactive protein; CT: computed-tomography; MRI: Magnetic resonance imaging; Spondylodiscitis; Tissue sampling; WCC: white cell count.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Discitis* / diagnostic imaging
  • Discitis* / surgery
  • Humans
  • Image-Guided Biopsy / methods
  • Intervertebral Disc* / diagnostic imaging
  • Intervertebral Disc* / pathology
  • Intervertebral Disc* / surgery
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods

Substances

  • Anti-Bacterial Agents