Value of CT-guided biopsy in the diagnosis of septic discitis.

Abstract

Aim: To determine the role of CT-guided biopsy in the management of cases of infective disctis

Methods: Retrospective case series of CT-guided biopsies for the five-year period ending June 2006

Results: Ninety-eight CT-guided biopsies were performed in the study period on 103 patients. Malignancy was diagnosed in 49 episodes. Discitis and paravertebral abscess accounted for 27 cases. Culture was positive in nine of 25 (36%) samples received by the microbiology laboratory. Staphylococcus aureus (four cases) and Mycobacterium tuberculosis (three cases) were the most frequent organisms isolated, followed by group G streptococcus and coagulase negative staphylococci (one case each). Blood cultures were diagnostic in a further nine patients. The main reason for a negative culture was prior antimicrobial therapy. The biopsy changed management in 9/25 (36%) of cases. There were no reported adverse events.

Conclusion: Septic discitis is a serious condition with a wide variety of infective causes. CT-guided biopsy is a useful tool when the diagnosis of infectious spinal infection is considered, in terms of commencing and targeting therapy, and is a safe and well-tolerated procedure.