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THU0432 Efficiency of Guided Discovertebral Biopsy in Infectious Spondylodiscitis
  1. I. Mahmoud1,
  2. A. Andia2,
  3. O. Saidane1,
  4. A. Ali1,
  5. R. Tekaya1,
  6. H. Sahli1,
  7. L. abdelmoula1,
  8. R. Zouari1
  1. 1Rheumatology
  2. 2HCN, Tunis, Tunisia

Abstract

Background Etiologic diagnosis is important for treatment and consequently for the prognosis of the patient with infectious spondylodiscitis. Unfortunately, this diagnosis can be difficult and the need of a guided discovertebral biopsy (GDVB) could be helpful.

Objectives The purpose of this retrospective study was to assess the performance of GDVB to determine the etiology of infectious spondylodiscitis.

Methods Patients hospitalized in Rheumatology department, between 1999 to 2012, for suspected diagnosis of infectious spondilodiscitis has been collected. Only patients who had a GDVB for etiologic diagnosis of infectious spondylodiscitis were included in this study.

Results 60 patients were included. The accurate arguments diagnosis was obtained in 32 %.

Then GDVB was profitable for tuberculosis by: tuberculosis culture, necrosis caseum with giganted cells in 17 % of case; for pyogenes germs it was also profitable in 15% (four cases for staphylococcus aureus one case for brucellosis, one case for Klebsiella oxytoca, one case for Serratia Marcescens, two cases for E.coili ). In 40 % of case the results was no specific with an inflammatory involvement in histopathologic exam: with a definitive diagnosis of tuberculosis in 20 cases and brucellosis in 4 cases. In 28% of case the results was without particularity, non interpretable or non transmitted (major case for tuberculosis, and brucellosis and pyogenes germs for the rest).

Conclusions Guided discovertebral biopsy is helpful for the diagnosis of infectious spondylodiscitis and should be done whenever this condition is suspected. The increased rates for no specific inflammatory involvement and no interpretable results could be reduced by respecting the guided discovertebral biopsy technical in order to biopsy the real lesions for different exams.

Disclosure of Interest None Declared

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