Low Back Surgery Can Cause Discitis

Even though discitis is an uncommon problem, it is a real post-operative complication which presents as low back pain worsening within 8 weeks of surgery (or maybe longer?). Maybe this patient had discitis immediately post-operatively that flew under the radar until the infection spread throughout the entire body. Sometimes infections are difficult to detect in the early stages. Sometimes the doctor's job is to stay vigilant until the disease rears its ugly head. Like in this case, infections like discitis can get ugly. The most common organism causing discitis is Staphylococcus Aureus (a common bacteria). The diagnosis is based on laboratory findings showing signs of infection. A CT scan or MRI can show total disc destruction and bone erosion from the infection. Ultimately, a disc biopsy may be required to determine which bug is causing the infection. Treatment usually entails removal of all the offending hardware where bacteria like to hide and intravenous antibiotics for six to eight weeks. The laboratory (C-reactive protein) values will then normalize as the infection is successfully treated.

I bring this case to your attention because badness can happen after spinal surgery. We all need to be attentive to the hoof beats of trouble. Typically, these hoof beats are common "horses", but sometimes the hoof beats are of those uncommon "zebras" like spinal discitis.