POSTOPERATIVE LUMBAR SPONDYLODISCITIS: INFLUENCE OF DISCECTOMY LEVEL AND COMORBIDITIES ON PAIN RELIEF AND HOSPITALIZATION DURATION

Abstract

Postoperative lumbar spondylodiscitis, although uncommon affecting approximately 3-5% of spinal disc surgeries remains a serious complication. Unlike primary vertebral osteomyelitis, this condition generally results from intraoperative contamination or unfavorable postoperative circumstances. The current study investigates the influence of comorbidities and other clinical parameters on the course and prognosis of postoperative spondylodiscitis occurring after lumbar disc herniation surgery. Materials and methods: We performed a retrospective, cross-sectional evaluation involving 85 patients diagnosed with postoperative lumbar spondylodiscitis between 2018 and 2024 at two tertiary care hospitals in Bucharest. Clinical data were retrospectively collected from patient records and included demographic variables, comorbidity profiles, discectomy level, latency from surgery to symptom onset, hospitalization duration, and Visual Analogue Scale (VAS) scores pre- and post-treatment. Comparative statistical analyses were conducted across clinically relevant subgroups, with a focus on comorbidity status. Results: Cardiovascular disease (CVD) and type II diabetes mellitus (DM) emerged as the predominant comorbidities. The lumbar region was the most frequently involved anatomical site, regardless of comorbidity presence. Patients with comorbidities were significantly older and exhibited extended hospital stays (Welch's t-test, p < 0.05). While comorbidity status did not significantly influence the mean time to symptom onset, complications such as fever and motor deficits were strongly associated with prolonged hospitalization. VAS scores improved substantially following treatment across all subgroups (p < 0.05); however, intergroup comparisons revealed no significant differences in pain reduction outcomes between patients with and without comorbidities. Conclusions: Pre-existing comorbidities are associated with a higher likelihood of postoperative lumbar spondylodiscitis and correlate with increased patient age and lengthier hospital stays. Nonetheless, the condition demonstrates a favorable response to treatment, particularly regarding pain reduction. These findings underscore the importance of early diagnosis and coordinated multidisciplinary care to improve clinical outcomes and mitigate long-term morbidity.