CT Fluoroscopy-Guided Transsacral Intervertebral Drainage for Pyogenic Spondylodiscitis at the Lumbosacral Junction

Journal Article · Sun Jan 15 04:00:00 EST 2017 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-016-1452-9· OSTI ID:22645365

Matsumoto, Tomohiro; Mine, Takahiko; Hayashi, Toshihiko ^[1]; Kamono, Masahiro; Taoda, Akiko; Higaki, Megumu ^[2]; Hasebe, Terumitsu ^[1]

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1. Tokai University School of Medicine, Department of Radiology, Tokai University Hachioji Hospital (Japan)
2. Tokai University School of Medicine, Department of General Internal Medicine, Tokai University Hachioji Hospital (Japan)

PurposeTo retrospectively describe the feasibility and efficacy of CT fluoroscopy-guided transsacral intervertebral drainage for pyogenic spondylodiscitis at the lumbosacral junction with a combination of two interventional radiological techniques—CT-guided bone biopsy and abscess drainage.Materials and methodsThree patients with pyogenic spondylodiscitis at the lumbosacral junction were enrolled in this study between July 2013 and December 2015. The procedure of CT fluoroscopy-guided transsacral intervertebral drainage for pyogenic spondylodiscitis at the lumbosacral junction was as follows: the sacrum at S1 pedicle was penetrated with an 11-gauge (G) bone biopsy needle to create a path for an 8-French (F) pigtail drainage catheter. The bone biopsy needle was withdrawn, and an 18-G needle was inserted into the intervertebral space of the lumbosacral junction. Then, a 0.038-inch guidewire was inserted into the intervertebral space. Finally, the 8-F pigtail drainage catheter was inserted over the guidewire until its tip reached the intervertebral space. All patients received six-week antibiotics treatment.ResultsSuccessful placement of the drainage catheter was achieved for each patient without procedural complications. The duration of drainage was 17–33 days. For two patients, specific organisms were isolated; thus, definitive medical therapy was possible. All patients responded well to the treatment.ConclusionsCT fluoroscopy-guided transsacral intervertebral drainage for pyogenic spondylodiscitis at the lumbosacral junction is feasible and can be effective with a combination of two interventional techniques—CT fluoroscopy-guided bone biopsy and abscess drainage.

• OSTI ID: 22645365
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 1 Vol. 40; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ABSCESSES
ANTIBIOTICS
BIOPSY
COMPUTERIZED TOMOGRAPHY
DRAINAGE
ELECTRIC CONTACTS
FLUOROSCOPY
PATIENTS
SEMICONDUCTOR JUNCTIONS
SKELETON
SUPERCONDUCTING JUNCTIONS
THERAPY