[Spondylodiscitis after surgery of lumbar disk hernia. Apropos of 12 cases in 1796 operations]. / Spondylodiscite après chirurgie de la hernie discale lombaire. A propos de 12 cas sur 1,796 opérés.

Discitis is a rare complication of disc operation. The incidence rate varies from 0.2 to 0.8% according to the series. During a 6 year period (1980-1986) 1,796 patients were operated for lumbar disc protrusion at our institution and twelve of them (0.66%) developed a post operative discitis. Bacteriologic verification due to the infection was ascertained in ten cases. Direct contamination during surgical time is likely far more frequent than hematogenous contamination because the liable germ was staphylococcus in 9 cases. Ascertaining the diagnosis is base upon clinical picture and some selected investigations. It may be earlier than it has been said before. Discitis may be suspected within a week after operation in two cases out of three. The most prominent clinical feature is back pain with muscle spasm but sometimes diagnosis may be misled to a psychiatric condition or a visceral disorder. Among conclusive investigations we range in the first place the needle aspiration of the disc which permitted to isolate a germ nine times out of eleven. Next the bone scan with H.M.D.P. Te 99 (8 Mbq/kg) which revealed a significant uptake pattern in eight cases out of eight. Finally the blood culture which grew five times out of ten. Risks of discitis, i.e septicemia, polysegmental infection or death justify in our opinion an appropriate antibiotherapy during at least 8 weeks. Moreover, in our experience, it is the best antalgic treatment that we can offer and back pain decreases as soon as the second day with antibiotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

[Strict correlation between anti-RANA antibodies and anti-EBNA antibodies apart from rheumatoid arthritis. Assessment of the diagnostic value of anti-RANA antibody]. / Corrélation étroite entre l'anticorps anti-RANA et l'anticorps anti-EBNA en dehors de la polyarthrite rhumatoïde. Critique de la valeur diagnostique de l'anticorps anti-RANA.

In order to study the relationship between anti-RANA antibodies (aRANA) and the antibodies capable of recognising other Epstein-Barr induced antigens, we examined the sera of 51 patients without rheumatoid arthritis for anti-RANA, anti-EA, anti-VCA, and anti-EBNA antibodies. These subjects were cases of Burkitt's lymphoma, infectious mononucleosis, naso-pharyngeal carcinoma, immune disorders, Hodgkin's disease and normal controls. A blind study was conducted in two separate laboratories. Anti-RANA was detected by indirect immunofluorescence on RAJI cells synchronised in phase G1. There was a very strict correlation between anti-RANA and anti-EBNA with no correlation between anti-RANA and anti-EA or anti-VCA. In another experiment, 15 coded sera from patients with classical rheumatoid arthritis were tested following adsorption of the rheumatoid factor. One serum was found to be devoid of both anti-RANA and anti-EBNA. These results demonstrate that anti-RANA is widely distributed outside of rheumatoid arthritis and they question the distinction between EBNA and RANA, as the antibody titres directed against these antigens are regularly linked together.