Publication:

Outcome of re-exploration and continuous irrigation with gentamicin-mixed normal saline via tri-channel Foley's catheter in postoperative discitis patients at a tertiary care hospital

Background Discitis, an inflammation of vertebral plates due to infection, can occur post-lumbar discectomy, affecting 0.2–4% of cases. This study assessed outcomes of re-exploration and continuous irrigation with gentamicin-normal saline via a tri-channel Foley catheter for postoperative discitis (POD).

Methods A retrospective observational study at Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh, analyzed 30 patients with POD post-lumbar disc surgery (March 2020–February 2022).

Results The mean age was 43.0±12.90 years, with L4/5 being the most affected level (60%). Persistent pain and fever were common (80%), with Staphylococcus aureus identified in 73.33% via blood cultures. Treatment showed significant improvements: erythrocyte sedimentation rate (ESR) reduced from 58.32±18.02 mm to 28.00±4.18 mm, CRP from 68.82±19.82 mg/l to 13.42±3.40 mg/l (both p<0.001), VAS scores from 7.52±1.73 to 1.32±1.59 (p<0.01), and JOA scores across sensory, motor, and activity parameters (p<0.01). Satisfactory outcomes were achieved in 80% of patients, with excellent results in 46.67% and good results in 33.33%.

Conclusions Continuous irrigation with gentamicin-normal saline was effective in reducing inflammation, improving functionality, and achieving favorable outcomes in the majority of patients.