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Occult spondylodiscitis after cervical intradiscal injection with radiopaque gelified ethanol, DiscoGel: A case report
Örebro University, School of Medical Sciences. Department of Orthopedic Surgery.ORCID iD: 0000-0002-3905-7210
Örebro University, School of Medical Sciences. Department of Orthopedic Surgery.ORCID iD: 0000-0002-7931-9617
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Orthopedic Surgery.ORCID iD: 0000-0002-7376-4664
2022 (English)In: Interdisciplinary Neurosurgery, E-ISSN 2214-7519, Vol. 28, article id 101453Article in journal (Refereed) Published
Abstract [en]

Background: A 25-year-old patient was treated for post-traumatic neck pain with intradiscal injections at the C3-4 and C4-5 levels using radiopaque gelified ethanol. After the injections, the axial neck pain increased. Laboratory infection parameters were normal despite the progressive disc destruction observed on CT scans at both index levels. The patient underwent debridement and anterior cervical discectomy and fusion. Staphylococcus epi-dermidis and Cutibacterium acnes grew in all the intraoperative cultures. The patient was subsequently treated with Rifampicin and Moxifloxacin and after 3 months no signs of infection were observed. CT scan showed solid fusion of the at the index segments 7 months postoperatively.

Conclusion: Infections after intradiscal injections are rare and we believe this is the first case describing iatrogenic spondylodiscitis after DiscoGel injection. When increased axial neck pain is experienced after injection with DiscoGel, post-operative spondylodiscitis should be suspected. Even if laboratory parameters are normal, examinations with MRI and CT should be performed and if these studies show signs of infection, surgical revision should be conducted.

Place, publisher, year, edition, pages
Elsevier, 2022. Vol. 28, article id 101453
Keywords [en]
Occult infection, ACDF, Discitis, Spondylodiscitis
National Category
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-96203DOI: 10.1016/j.inat.2021.101453ISI: 000734875800011Scopus ID: 2-s2.0-85121228444OAI: oai:DiVA.org:oru-96203DiVA, id: diva2:1625488
Available from: 2022-01-07 Created: 2022-01-07 Last updated: 2022-01-07Bibliographically approved

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Holy, MarekJoelson, AndersSigmundsson, Freyr Gauti

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