Discitis

Inflammation of an INTERVERTEBRAL DISC or disk space which may lead to disk erosion. Until recently, discitis has been defined as a nonbacterial inflammation and has been attributed to aseptic processes (e.g., chemical reaction to an injected substance). However, recent studies provide evidence that infection may be the initial cause, but perhaps not the promoter, of most cases of discitis. Discitis has been diagnosed in patients following discography, myelography, lumbar puncture, paravertebral injection, and obstetrical epidural anesthesia. Discitis following chemonucleolysis (especially with chymopapain) is attributed to chemical reaction by some and to introduction of microorganisms by others.

Also Known As:

Networked: 1031 relevant articles (88 outcomes, 111 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Infections
2.	Osteomyelitis
3.	Abscess
4.	Fistula
5.	Wounds and Injuries (Trauma)

Experts

1.	Tsai, Tsung-Ting: 9 articles (12/2021 - 01/2010)
2.	Chen, Wen-Jer: 9 articles (11/2020 - 01/2010)
3.	Fu, Tsai-Sheng: 9 articles (08/2019 - 01/2010)
4.	Meyer, Bernhard: 7 articles (04/2022 - 11/2010)
5.	Lai, Po-Liang: 7 articles (08/2019 - 01/2010)
6.	Niu, Chi-Chien: 7 articles (08/2019 - 01/2011)
7.	Chen, Lih-Huei: 7 articles (01/2019 - 01/2010)
8.	Shiban, Ehab: 5 articles (04/2022 - 06/2014)
9.	Pola, Enrico: 5 articles (03/2022 - 07/2014)
10.	Janssen, Insa: 4 articles (04/2022 - 06/2014)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Discitis:

1.	Anti-Bacterial Agents (Antibiotics)IBA 01/01/2020 - "Despite negative blood cultures and CT-guided biopsy results, empirical intravenous antibiotics were effective in treating discitis successfully. " 03/01/2019 - "A rare case of antibiotic-resistant multi-level spondylodiscitis due to MAC was treated successfully with multi-stage surgical treatment. " 12/01/2008 - "Spondylodiscitis was confirmed by a magnetic resonance imaging and the treatment was non-esteroidal anti-inflammatory and analgetics drug, with good results, and prolongation of antibiotic treatment up to 3 months. " 10/01/2019 - "Safety and efficacy of percutaneous instrumentation combined with antibiotic treatment in spondylodiscitis." 12/01/2010 - "Discitis occurred in 1 case at 3 days after operation and was cured after 3 weeks of antibiotic use. "
2.	VancomycinFDA LinkGeneric 10/15/2006 - "Vancomycin is currently the gold standard treatment for medical management of MRSA discitis. " 01/01/2013 - "The aim of the present study was to investigate the local pharmacokinetic properties and the systemic safety of vancomycin-impregnated cancellous bone grafts in the treatment of spondylodiscitis. " 10/01/2014 - "First report of spondylodiscitis due to vancomycin heteroresistant Staphylococcus capitis in immunocompetent host." 01/01/2013 - "Pharmacokinetic properties and systemic safety of vancomycin-impregnated cancellous bone grafts in the treatment of spondylodiscitis." 07/01/2012 - "The purpose of this study was to assess the efficacy of diode laser combined with intradiscal vancomycin for iatrogenic discitis (ID) infected with Staphylococcus aureus. "
3.	C-Reactive ProteinIBA 09/01/2023 - "However, C-reactive protein, erythrocyte sedimentation rate, and white blood cells were significantly different in the pyogenic spondylodiscitis group, with medians of 121 mg/dL (P = .03), 82 mmol/h (P = .04), and 11.2 × 109/L (P = .014), respectively. " 01/01/2022 - "Low-risk criteria are proposed: good general condition, no underlying disease, 6 months to 3 years old, appropriate oral tolerance, C-reactive protein <80 mg/L, erythrocyte sedimentation rate/C-reactive protein ratio ≥0.67, no skin injury, no recent surgery, no cervical spondylodiscitis and no local complications at onset." 01/01/2022 - "Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values were found to be higher in patients who had Brucellar spondylodiscitis. " 01/01/2021 - "Serum C-reactive protein and WBC count in conservatively and operatively managed bacterial spondylodiscitis." 12/01/2019 - "Blood routine examination, erythrocyte sedimentation rate, C-reactive protein, and magnetic resonance imaging (MRI) of the lumbar spine indicated lumbar pyogenic spondylodiscitis. "
4.	polyetheretherketoneIBA 01/01/2023 - "The PEEK cage and cadaveric allograft combined with local bone grafts is a safe and effective choice for intervertebral fusion and restoring sagittal alignment without increased incidence of relapse for treating lumbar pyogenic spondylodiscitis." 08/24/2023 - "Efficacy of Minimally Invasive Oblique Lumbar Interbody Fusion Using Polyetheretherketone Cages for Lumbar Pyogenic Spondylodiscitis Treatment." 01/01/2023 - "Safety and Efficacy of Polyetheretherketone (PEEK) Cages and Cadaveric Allografts in Transforaminal Lumbar Interbody Fusion (TLIF) for Treating Lumbar Pyogenic Spondylodiscitis." 08/24/2023 - "(1) Background: This study evaluated the efficacy and safety of a minimally invasive oblique lumbar interbody fusion (OLIF) using polyetheretherketone (PEEK) cages for the treatment of lumbar pyogenic spondylodiscitis. " 01/01/2023 - "This study sought to evaluate the safety and effectiveness of PEEK cages and the cadaveric allograft in transforaminal lumbar interbody fusion (TLIF) for treating lumbar pyogenic spondylodiscitis. "
5.	Linezolid (Zyvox)FDA Link 07/01/2010 - "We report a case of a 42-year-old man presented with a black discoloration of his tongue during treatment with linezolid for spondylodiscitis. " 11/01/2023 - "Therapeutic drug monitoring-enabled long-term use of linezolid for the successful treatment of refractory pyogenic spondylodiscitis without development of thrombocytopenia: A case report." 09/01/2010 - "We report the case of an immunocompetent child with spondylodiscitis as a result of staphylococcal sepsis, which was successfully treated with linezolid. " 08/01/2008 - "Early linezolid-associated lactic acidosis in a patient treated for tuberculous spondylodiscitis." 09/01/2010 - "Linezolid therapy for pediatric thoracic spondylodiscitis due to Staphylococcus aureus sepsis."
6.	Fluconazole (Zonal)FDA LinkGeneric 09/01/2010 - "Successful treatment of Candida discitis with 5-flucytosine and fluconazole." 07/01/1996 - "We report the cases of two patients with spondylodiskitis due to Candida albicans who were successfully treated with fluconazole. " 07/01/1996 - "Spondylodiskitis due to Candida albicans: report of two patients who were successfully treated with fluconazole and review of the literature." 01/01/1998 - "Fluconazole therapy in Candida albicans spondylodiscitis." 07/01/2005 - "Oral fluconazole appears to be useful in the management of candida spondylodiscitis complicated by epidural abscess formation. "
7.	Rifampin (Rifampicin)FDA LinkGeneric 02/01/2019 - "The aim of the study is to report the clinical characteristics, early diagnosis, management, and outcome of children with multidrug-resistant (MDR) tubercular spondylodiscitis and to assess the early detection of rifampicin resistance using the Xpert MTB/ RIF assay. " 12/01/2017 - "This study recommends Xpert MTB/RIF assay for early detection of Mycobacterium tubercular spondylodiscitis and Rifampicin resistance." 12/01/2017 - "This study aims to assess the accuracy of the Xpert MTB/RIF assay in the diagnosis of tubercular spondylodiscitis and to identify its role in detecting Rifampicin resistance in patients with infective spondylodiscitis. " 12/28/2020 - "We describe the development of a flu-like syndrome in a patient undergoing extended antimicrobial therapy with rifampin for discitis and an associated device-related infection, which promptly resolved with discontinuation of rifampin. While the flu-like syndrome has been documented in prior literature covering the treatment of tuberculosis (where the dose regimen tends to be intermittent) there is less evidence for its occurrence in the treatment of device-related infections (which tend to be dosed daily)." 04/01/2009 - "Our findings suggest that high-dose levofloxacin regimens may be highly effective in the treatment of non-tuberculous spondylodiscitis and support its putative role in combination with rifampicin against S. "
8.	Cefazolin (Ancef)FDA LinkGeneric 02/15/2006 - "A single prophylactic 2-g dose of cephazolin administered anytime over a 4-hour period prevented discitis in almost all animals but was not as effective in lambs. " 09/01/2006 - "Preventing and treating discitis: cephazolin penetration in ovine lumbar intervertebral disc." 02/15/2006 - "Discitis did not develop in any of the sheep that received cephazolin 30 minutes before inoculation. " 02/15/2006 - "Of those animals given cephazolin, discitis developed in 1 sheep and 4 lambs. " 02/15/2006 - "To determine in juvenile and adult sheep spines if 2-g cephazolin given at intervals over a 4-hour period would prevent iatrogenic discitis, and determine the concentration of cephazolin in nucleus and anulus tissue after administration of a bolus dose. "
9.	Gentamicins (Gentamicin)FDA LinkGeneric 03/01/1998 - "Gentamicin-containing collagenous sponges placed in the cleared disc space were effective in preventing postoperative spondylodiscitis." 01/01/2022 - "Further studies are needed to establish a safe treatment protocol for treatment with gentamicin and LM spondylodiscitis." 04/01/2021 - "We currently recommend a leukocyte-rich PRP and a two-needle delivery technique coupled with intradiscal gentamicin to mitigate the risk of postinjection spondylodiscitis. " 09/01/2002 - "We therefore recommend the use of gentamicin in a single prophylactic dose for all spinal procedures in order to reduce the risk of discitis." 01/01/2022 - "Spontaneous spondylodiscitis and epidural abscess due to Listeria monocytogenes in a middle-aged patient with gentamicin related side effects: A case report and a review of literature."
10.	dalbavancinIBA 10/01/2022 - "Our study suggests that Dalbavancin could be an effective and safe option in treating spondylodiscitis, however, the scarcity of studies on the topic is concerning. " 10/08/2022 - "Methods: We retrospectively included all patients >18 years of age with spondylodiscitis that is caused by MRSA that was treated with dalbavancin from January 2018−January 2021, recording the instances of clinical cure/failure, adverse events, and the need to be re-hospitalized after the initiation of dalbavancin. " 10/08/2022 - "Background: Our aim was to describe the clinical outcome and safety of the sequential treatment with off-label dalbavancin in patients with spondylodiscitis that is caused by methicillin-resistant Staphylococcus aureus (MRSA). " 10/01/2022 - "All adult patients diagnosed with spondylodiscitis and treated with dalbavancin were included across four Italian medical centers from January 2018 to April 2021. " 10/01/2022 - "Dalbavancin treatment for spondylodiscitis: multi-center clinical experience and literature review."

Therapies and Procedures

1.	Debridement 04/01/2020 - "Conclusion: In carefully selected patients, single-segment lumbar pyogenic spondylodiscitis can be cured successfully with continuous epidural irrigation and drainage combined with posterior debridement and posterior lumbar inter-body fusion. " 04/01/2012 - "The segments were probably fused in 5 patients and questionable in 2. Posterior debridement and instrumentation was adequate for single-segment spondylodiscitis and achieved good outcomes." 05/01/2008 - "An anterior approach for debridement and fusion with autologous bone graft has been recommended as the gold standard for surgical treatment of pyogenic spondylodiscitis. " 12/01/2012 - "The posterior approach with long segmental fixation and short posterior or posterolateral fusion without debridement of the infected tissue was effective for pyogenic spondylodiscitis of the thoracic and lumbar spine." 01/01/2022 - "The endoscopic debridement of spondylodiscitis seems to be an effective and safe approach for refractory spondylodiscitis. "
2.	Therapeutics 12/01/2017 - "The aim of the present study is the optimisation of the therapy of spondylodiscitis using a clinical pathway that depends on a classification of spondylodiscitis. " 02/01/2011 - "This study shows that CT scan not only plays a decisive role in early positive diagnosis of spondylodiscitis but also contributes to therapy by guiding biopsy to obtain samples necessary to identify the causal germ and assess disco-vertebral involvement. " 09/01/1989 - "This study reported on the anamnesis, clinical and instrumental findings as well as therapy in a girl with discitis. " 11/14/2023 - "Pyogenic spondylodiscitis in HIV-positive patients under antiretroviral therapy: A case series." 05/01/2023 - "After 1 month of starting anti-TB therapy, we found a paradoxical worsening of her symptoms and further deterioration of radiological features showing extensive tubercular spondylodiscitis involving almost all the vertebral with extensive prevertebral and paravertebral soft tissue collections. "
3.	Pedicle Screws 04/01/2023 - "These results indicate that extreme lateral interbody fusion topped off with a percutaneous pedicle screw fixation might be a feasible, safe and valuable choice to surgically treat patients with spondylodiscitis with fast and important improvement in VAS. " 03/01/2017 - "This study demonstrates that the robot-guided insertion of pedicle screws is a safe and effective procedure in lumbar and thoracic spondylodiscitis with higher accuracy of implant placement, lower radiation dose, and decreased complication rates. " 12/18/2014 - "The aim of this study, therefore, was to determine whether percutaneous posterior pedicle screw instrumentation is superior to the traditional open approach in treating pyogenic spondylodiscitis. " 01/01/2021 - "The aim of this study was to investigate the suitability of percutaneous posterior pedicle screw fixation for surgical treatment in patients with spondylodiscitis of the thoracolumbar spine. " 12/01/2019 - "The aim of the present study was to investigate the efficacy and safety of the oblique lateral interbody fusion (OLIF) corridor approach combined with posterior pedicle screw fixation for treating pyogenic spondylodiscitis. "
4.	Conservative Treatment 01/01/2018 - "Good outcomes were previously reported for percutaneous suction aspiration and drainage (PSAD) in the treatment of infective spondylodiscitis resistant to conservative therapy. " 01/01/2015 - "Discitis secondary to possible thermal injury occurred in 2 (0.1%) patients and this complication was improved with conservative treatment. " 01/01/2015 - "This review article suggested that majority of postoperative spondylodiscitis without internal fixation could be cured by conservative treatment. " 10/01/2010 - "This article presents a case of a patient with brucellar spondylodiscitis, affecting simultaneously the cervical, thoracic and lumbar spine, who had responded well to conservative management." 02/01/2005 - "To analyze and assess the clinical, laboratory, and radiologic findings in children with spondylodiscitis and to document the efficacy of conservative treatment based on the long-term clinical, functional, and radiologic outcomes of these patients. "
5.	Diskectomy (Discectomy) 02/01/2001 - "Previous failed surgery after discectomy, nonunion or biologically cured discitis were other indications in selected cases. " 08/01/2021 - "Patients who underwent discectomy were observed and those presenting with postoperative discitis were included in the study. " 10/13/2023 - "Patients had undergone single-level L4-L5 or L5-S1 discectomy elsewhere, later developing magnetic resonance imaging-confirmed discitis. " 07/01/2023 - "We report the management of two cases of postoperative spondylodiscitis caused by Ralstonia mannitolilytica presenting to our center within a span of one month following endoscopic lumbar discectomy at a different center. " 07/01/2023 - "Ralstonia mannitolilytica as a rare cause of spondylodiscitis following endoscopic lumbar discectomy- A report of two cases."