The Rae of Spondylodiscitis in Patients with Lomber Discectomy Using Single Dose Prophylactic is Antibiotics

Abstract

Objective: The incidence of spondylodiscitis following lumbar discectomy has been reported to range between 0.1\% and 18.8\% by various authors. The most common pathogen is Staphylococcus aureus. Methods: We collected retrospectively the medical records of 1154 patients who had the single-level or two-level disc herniation and were operated for lumbar microdiscectomy between 2007 and 2015 in our hospital. Of them, 554 were female and 600 were male. A total of 1062 patients underwent single-level, 91-level two-level lumbar microdiscectomy. All of these patients were given prophylactic single-dose cefazoline sodium during anesthesia in accordance with the recommendations of the surgical antimicrobial prophylaxis guidelines. Spondylodiscitis developed in 12 patients (1.03\%). The comorbidities in patients treated for spondylodiscitis, isolated pathogens, antibiotic susceptibility, antibiotics used, and hospital stay were recorded. Results: Of the 12 patients, 7 were female and 5 were male. The mean age was 45.75 +/- 14.16 years. Eleven patients underwent single-level, and 1 two-level lumbar microdiscectomy procedures. 5 patients underwent discectomy from L4-5 and 8 patients from L5-S1 levels. Staphylococcus aureus was present in 3 patients (25\%), Staphylococcus epidermidis in 4 (33\%), Escherichia coil in 3 (25\%), and 2 patients had no detected pathogens. The mean duration of hospital stay was 29.45 +/- 3.98 days, and in patients without spondylodiscitis, it was 1.99 +/- 0.81 days, meaning that there was a significant difference between these groups (p=0.0001). Conclusion: Although most surgeons tend to maintain antibiotic prophylaxis postoperatively or during the hospitalization period, our study found that a single dose prophylactic antibiotic administered during anesthesia induction did not increase the rate of spondylodiscitis, compared to the results found in the medical literature.