Postoperative discitis

SymptomsT45 discitis


Period of pain relief after disc surgery

- followed by increasing back pain & occasional leg pain


Pain may be disproportionate to physical findings


Low grade fever common


SLR & femoral stretch tests elicit pain in some cases 




Normal WCC common 

ESR & CRP elevated 


Xray / MRI


Discitis XrayDiscitis MRI


MRI with Gadolinium


Investigation of choice

- well vascularized inflammatory tissue enhances on T1


MRI Gadolinium Post Operative Discitis T1MRI Gadolinium Post Operative Discitis T2


Osteomyelitis changes include

- confluent hypointensity of involved bodies on T1

- hyperintensity of involved bone and disc on T2

- loss of distinction of involved bone & disc

- abnormal disc appearance




Medical management


CT guided aspirate if culture required

- appropriate antibiotics

- brace


Surgical Indications


Failure non operative management

Epidural abscess



Post Op Discitis with Deformity




1.  Percutaneous Discectomy and Drainage


Li et al Arch Orthop Trauma Surg 2011

- 31 patients with post-operative discitis

- half had positive cultures, other half sterile


2.  Laminectomy and Drainage