Comparison of CT-Guided needle biopsy versus percutaneous endoscopic debridement and drainage in pathogen identification and pain outcomes for spondylodiscitis patients: A systematic review and literature review
Introduction: Spondylodiscitis (SD) is an infection of the intervertebral disc with involvement of the adjacent vertebral bodies. Diagnostic tests with CT-guided biopsy only provide a positive yield in 14%–48% of cases. Percutaneous endoscopic debridement and drainage (PEDD) has recently shown promi...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529424001103 |
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| author | Nischal Acharya Joshua S. Kurtz Kylie T. Callan Gabrielle E.A. Hovis Scarlett R.K. Mar Alexander Lopez Alvin Y. Chan Hao-Hua Wu Sohaib Z. Hashmi Nitin N. Bhatia Michael Y. Oh |
| author_facet | Nischal Acharya Joshua S. Kurtz Kylie T. Callan Gabrielle E.A. Hovis Scarlett R.K. Mar Alexander Lopez Alvin Y. Chan Hao-Hua Wu Sohaib Z. Hashmi Nitin N. Bhatia Michael Y. Oh |
| author_sort | Nischal Acharya |
| collection | DOAJ |
| description | Introduction: Spondylodiscitis (SD) is an infection of the intervertebral disc with involvement of the adjacent vertebral bodies. Diagnostic tests with CT-guided biopsy only provide a positive yield in 14%–48% of cases. Percutaneous endoscopic debridement and drainage (PEDD) has recently shown promise in the treatment of spondylodiscitis. Research question: The purpose of this study is to determine differences in pathogen identification and clinical outcomes for PEDD versus CT-guided needle biopsy in SD patients. Materials and methods: We conducted a systematic review of the literature using PRISMA guidelines to determine differences in positive microbiology results, perioperative complications, pain control, and long-term clinical outcomes for PEDD vs. CT-guided needle biopsy in SD patients. Results: 1078 studies were evaluated, 87 of which underwent full review. 15 studies met the inclusion and exclusion criteria, including 7 PEDD, 7 CT-guided biopsy, and 1 CT-guided biopsy vs. PEDD article, for a total of 192 PEDD patients and 604 CT-guided biopsy patients. We found 36.59% of CT-guided biopsy patients had positive microbiology results, compared to 84.38% of PEDD patients. No major perioperative complications occurred as a result of the PEDD procedure. Of the five PEDD studies that reported pain outcomes, greater than 80% of patients experienced relief after intervention. Discussion and conclusion: These results suggest that PEDD may improve pathogen identification while simultaneously reducing pain compared to CT-guided needle biopsy in SD. Although current treatment guidelines recommend CT-guided biopsy, in patients with severe back pain and suspected SD, PEDD can be considered an alternative intervention. |
| format | Article |
| id | doaj-art-2f8be7233c0249ab9f17ba0f6a793b2d |
| institution | OA Journals |
| issn | 2772-5294 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-2f8be7233c0249ab9f17ba0f6a793b2d2025-08-20T01:56:24ZengElsevierBrain and Spine2772-52942024-01-01410285410.1016/j.bas.2024.102854Comparison of CT-Guided needle biopsy versus percutaneous endoscopic debridement and drainage in pathogen identification and pain outcomes for spondylodiscitis patients: A systematic review and literature reviewNischal Acharya0Joshua S. Kurtz1Kylie T. Callan2Gabrielle E.A. Hovis3Scarlett R.K. Mar4Alexander Lopez5Alvin Y. Chan6Hao-Hua Wu7Sohaib Z. Hashmi8Nitin N. Bhatia9Michael Y. Oh10Department of Neurological Surgery, University of California, Irvine Medical Center, Orange, CA, USADepartment of Neurological Surgery, University of California, Irvine Medical Center, Orange, CA, USADepartment of Orthopaedic Surgery, University of California, Irvine Medical Center, Orange, CA, USADepartment of Neurological Surgery, University of California, Irvine Medical Center, Orange, CA, USADepartment of Neurological Surgery, University of California, Irvine Medical Center, Orange, CA, USADepartment of Neurological Surgery, University of California, Irvine Medical Center, Orange, CA, USADepartment of Neurological Surgery, University of California, Irvine Medical Center, Orange, CA, USADepartment of Orthopaedic Surgery, University of California, Irvine Medical Center, Orange, CA, USADepartment of Orthopaedic Surgery, University of California, Irvine Medical Center, Orange, CA, USADepartment of Orthopaedic Surgery, University of California, Irvine Medical Center, Orange, CA, USADepartment of Neurological Surgery, University of California, Irvine Medical Center, Orange, CA, USA; Corresponding author.Introduction: Spondylodiscitis (SD) is an infection of the intervertebral disc with involvement of the adjacent vertebral bodies. Diagnostic tests with CT-guided biopsy only provide a positive yield in 14%–48% of cases. Percutaneous endoscopic debridement and drainage (PEDD) has recently shown promise in the treatment of spondylodiscitis. Research question: The purpose of this study is to determine differences in pathogen identification and clinical outcomes for PEDD versus CT-guided needle biopsy in SD patients. Materials and methods: We conducted a systematic review of the literature using PRISMA guidelines to determine differences in positive microbiology results, perioperative complications, pain control, and long-term clinical outcomes for PEDD vs. CT-guided needle biopsy in SD patients. Results: 1078 studies were evaluated, 87 of which underwent full review. 15 studies met the inclusion and exclusion criteria, including 7 PEDD, 7 CT-guided biopsy, and 1 CT-guided biopsy vs. PEDD article, for a total of 192 PEDD patients and 604 CT-guided biopsy patients. We found 36.59% of CT-guided biopsy patients had positive microbiology results, compared to 84.38% of PEDD patients. No major perioperative complications occurred as a result of the PEDD procedure. Of the five PEDD studies that reported pain outcomes, greater than 80% of patients experienced relief after intervention. Discussion and conclusion: These results suggest that PEDD may improve pathogen identification while simultaneously reducing pain compared to CT-guided needle biopsy in SD. Although current treatment guidelines recommend CT-guided biopsy, in patients with severe back pain and suspected SD, PEDD can be considered an alternative intervention.http://www.sciencedirect.com/science/article/pii/S2772529424001103SpondylodiscitisVertebral osteomyelitisPercutaneous endoscopic debridement and drainagePEDDCT-Guided needle biopsy |
| spellingShingle | Nischal Acharya Joshua S. Kurtz Kylie T. Callan Gabrielle E.A. Hovis Scarlett R.K. Mar Alexander Lopez Alvin Y. Chan Hao-Hua Wu Sohaib Z. Hashmi Nitin N. Bhatia Michael Y. Oh Comparison of CT-Guided needle biopsy versus percutaneous endoscopic debridement and drainage in pathogen identification and pain outcomes for spondylodiscitis patients: A systematic review and literature review Brain and Spine Spondylodiscitis Vertebral osteomyelitis Percutaneous endoscopic debridement and drainage PEDD CT-Guided needle biopsy |
| title | Comparison of CT-Guided needle biopsy versus percutaneous endoscopic debridement and drainage in pathogen identification and pain outcomes for spondylodiscitis patients: A systematic review and literature review |
| title_full | Comparison of CT-Guided needle biopsy versus percutaneous endoscopic debridement and drainage in pathogen identification and pain outcomes for spondylodiscitis patients: A systematic review and literature review |
| title_fullStr | Comparison of CT-Guided needle biopsy versus percutaneous endoscopic debridement and drainage in pathogen identification and pain outcomes for spondylodiscitis patients: A systematic review and literature review |
| title_full_unstemmed | Comparison of CT-Guided needle biopsy versus percutaneous endoscopic debridement and drainage in pathogen identification and pain outcomes for spondylodiscitis patients: A systematic review and literature review |
| title_short | Comparison of CT-Guided needle biopsy versus percutaneous endoscopic debridement and drainage in pathogen identification and pain outcomes for spondylodiscitis patients: A systematic review and literature review |
| title_sort | comparison of ct guided needle biopsy versus percutaneous endoscopic debridement and drainage in pathogen identification and pain outcomes for spondylodiscitis patients a systematic review and literature review |
| topic | Spondylodiscitis Vertebral osteomyelitis Percutaneous endoscopic debridement and drainage PEDD CT-Guided needle biopsy |
| url | http://www.sciencedirect.com/science/article/pii/S2772529424001103 |
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