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  • Title: New needle biopsy technique for lumbar pyogenic spondylodiscitis.
    Author: Shibayama M, Nagahara M, Kawase G, Fujiwara K, Kawaguchi Y, Mizutani J.
    Journal: Spine (Phila Pa 1976); 2010 Nov 01; 35(23):E1347-9. PubMed ID: 20938383.
    Abstract:
    STUDY DESIGN: Case series. OBJECTIVE: To improve the isolation rate for pyogenic spondylodiscitis, we developed a new needle biopsy technique. SUMMARY OF BACKGROUND DATA: 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%. METHODS: 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. RESULTS: 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%). CONCLUSION: This simple method improved the isolation rate and should improve the treatment of lumbar pyogenic spondylodiscitis.
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