The effectiveness of vancomycin injection in disc space during lumbar discectomy in prevention of postoperative discitis

Qatran Raheem, Hayder

	The effectiveness of vancomycin injection in disc space during lumbar discectomy in prevention of postoperative discitis
Mustansiriya Medical Journal
Article 1, Volume 11, Issue 2, 2012, Pages 11-14
Author
Hayder Qatran Raheem
Abstract
Background: Post discectomy disc space infection is relatively uncommon 4 %; nevertheless it is the most disabling causes of failed back surgery. Aims: To assess the effectiveness of intra-discal vancomycin in discectomy operation, we evaluated operative time, blood loss, postoperative complications (discitis) by measuring CRP, ESR and temperature in the preoperative and postoperative period. Blood culture was done in complicated case postoperatively. Social habit (smoking & drinking alcohol) and past medical history (Diabetes Mellitus) had been taking in consideration. Patients and Methods: This is a prospective study on 150 patients operated upon by lumber discectomy, 75 cases have been treated by injection of 4 ml of (2 mg/ml) vancomycin in the disc space that removed while in the other 75, 4 ml of normal saline was injected in the disc space (placebo). Results: There were 6 cases of postoperative discitis, all in the placebo group. There were 4 men and 2 women, ranging in age between 26 and 63 years. 3 were diabetics. All cases were in L4-5 disc space. The frequency of discitis was (4 %).In vancomycin group the frequency was 0% and in placebo group 6/75 (8 %). Conclusions: We concluded that the intra-operative prophylaxis with vancomycin intra-discaly is effective in prevention of postoperative discitis.
Keywords
Lumber discectomy; Discitis; Vancomycin; prevention

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