New needle biopsy technique for lumbar pyogenic spondylodiscitis.

Abstract

Case series. To improve the isolation rate for pyogenic spondylodiscitis, we developed a new needle biopsy technique. The biggest problem in treating lumbar pyogenic spondylodiscitis is a low success rate in isolating a causative microorganism. The rates have been reported 42% to 64%. There are 3 steps: (A) Insert a 21-G needle as for discography, aspirate pus or fluid as specimen. (B) If step A fails, inject saline and collect fluid as reflux. (C) If step B fails, insert another needle into the disc, inject saline and collect reflux from the other needle. We applied this approach to 12 patients with a mean age of 64.3 years. We were able to collect fluid samples in all cases and the culture was positive in 11 cases (91.6%). Staphylococcus aureus was the most frequently identified organism (41.7%). This simple method improved the isolation rate and should improve the treatment of lumbar pyogenic spondylodiscitis.