Study Design: 83 consecutive microdiskectomies were performed and evaluated to discern the efficacy of pre-operative prophylactic antibiotics ( cefazolin and vancomycin).
Objective: The objective of this preliminary report was to evaluate the amount, time of administration, effectiveness, and need of prophylactic antibiotics using our surgical results.
Summary of Background Data: Previous studies have yielded conflicting results regarding the role of antibiotics in prevention and treatment of discitis , and in their ability to penetrate the intervertebral disc.
Methods: 1gm of cefazolin was intravenously administered to 76 patients, 30 minutes prior to incision; 500mg of vancomycin was likewise administered to the remaining 7 patients who were allergic to cepbalosporins. No post-operative antibiotic was administered.
Results: Of the 83 consecutive surgeries, no patient developed iatrogenic disci tis. The average length of follow-up was 6 months (range 1 - 23 months).
Conclusions: Our results suggest that the use of cephalosporins (and glycopeptides) seems to prevent discitis when intravenously administered 30 minutes prior to surgery; that being the case, there appears to be no advantage in additional post-operative dosing. However, in light of conflicting reports and the preliminary nature of this study, conceivably there is another explanation. Perhaps there is in fact no correlation between pre-operative antibiotics and post-operative discitis.
Hodges, Scott D. and McClarty, Stacey J., "Discitis Following Microdiskectomy: A Preliminary Report on the Role of Pre-Operative Prophylactic Antibiotics" (1996). Senior Research Projects. 117.