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

M. Mahamudul H. Morshed; Avijit Dey; Saumitra Sarkar; Mohammad A. S. Miah; M. Shamsul I. Khan; Pankoj K. Mondol; Shahanaz Parvin; Saiful Hoque

doi:10.18203/2349-2902.isj20250557

Authors

M. Mahamudul H. Morshed Department of Neuro Surgery, Chattagram Medical College, Chattagram, Bangladesh
Avijit Dey Department of Neuro Surgery, Shaheed Suhrawardy Medical College and Hospital, Dhaka, Bangladesh
Saumitra Sarkar Department of Neuro Surgery, Shaheed Suhrawardy Medical College and Hospital, Dhaka, Bangladesh
Mohammad A. S. Miah Department of Paediatric Nephrology, Mymensingh Medical College, Mymensingh, Bangladesh
M. Shamsul I. Khan Department of Spine Neuro Surgery, Dhaka Medical College, Dhaka, Bangladesh
Pankoj K. Mondol Department of Orthopaedics Oncology and Musculoskeletal Tumor, National Institute of Cancer Hospital and Research, Dhaka, Bangladesh
Shahanaz Parvin Department of Obstetrics and Gynaecology, Delta Medical College, Dhaka, Bangladesh
Saiful Hoque Department of Obstetrics and Gynaecology, Delta Medical College, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-2902.isj20250557

Keywords:

Postoperative discitis, Irrigation, Gentamicin, Normal saline, Tri-channel Foley's catheter

Abstract

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.

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