375 Discitis – A large cohort analysis of its management in a tertiary orthopaedics centre

Abstract Aim Discitis is characterized as an infection of the intervertebral disc. It classically presents with fever and back pain. However, varied presentation and lack of adherence to guidelines leads to significant variation in its identification and management. We assessed adherence to guidelines, in the management of Discitis, in a tertiary orthopaedic centre. Method A retrospective study was conducted in a tertiary orthopaedic centre, between January 2017-September 2019. The study analysed patients with Magnetic Resonance Imaging (MRI) proven discitis. Results Out of the 305 spine MRIs reported as discitis, 152 (35%) had discitis based on imaging and only 38 patients (55%) clinically correlating, presenting symptoms. Back pain (47.3%) was the most common presenting complaint followed by fever. The commonest site of involvement was the lumbar vertebrae (70.4%). All patients had a baseline C-reactive protein and 34 (92.11%) had blood cultures taken. 70.5% patients with negative blood culture had Computerised Tomography (CT) -guided biopsy. Staphylococcus aureus was the most commonly isolated organism. Treatment was commonly with intravenous Flucloxacillin with 63% of the patients being treated for 6 weeks or more. Conclusions A structured follow up protocol will now be implemented within our centre. This will aim on correcting common errors within the management of discitis, including blood cultures prior to starting antibiotics and CT guided biopsies if blood cultures remain negative. We hope that the above will help achieve higher success rate in outcome of discitis.