Background: Thoracic ossification of the ligamentum flavum (OLF) and tuberculous infective spondylodiscitis rarely combine to cause paraplegia. Here, a 48-year-old female with both thoracic OLF and tuberculous spondylodiscitis experienced the acute onset of paraplegia successfully managed with a T8-L1 laminectomy with fusion.
Case Description: A 48-year-old female presented with the acute onset of paraplegia attributed to magnetic resonance-documented thoracic OLF and infective spondylodiscitis. Imaging revealed spinal cord compression (i.e., occupying >50% of the spinal canal) from D8 to D10 level and infective spondylodiscitis at the D10-D11 level. Surgery included a D8-L1 laminectomy with instrumented fusion. Histology and cultures revealed the presence of tuberculosis, and anti-tubercular therapy was administered. Both surgery and continued antibiotic therapy contributed to neurological improvement.
Conclusion: Thoracic OLF combined with tuberculous spondylodiscitis may be effectively treated with decompression, fusion, and appropriate anti-tubercular therapy.
Keywords: Dorsal spine, Infective spondylodiscitis, Koch's, Neurological deficit, Ossified ligamentum flavum (OLF), Paraplegia, Tuberculosis spine instability score (TSIS).
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http://dx.doi.org/10.25259/SNI_583_2024 | DOI Listing |
Brain Spine
December 2024
Department of Neurosurgery, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Introduction: The role of low-pathogenic bacteria cultured from removed spinal implants is unclear and the efficacy of perioperative single-dose antibiotics against such bacteria remains underexplored.
Research Question: This study aims to investigate whether pedicle screw loosening is associated with pathogens and if the choice of perioperative antibiotics can prevent these bacteria.
Methods: A retrospective analysis was conducted on 93 patients with implants removed between 01/01/2018 and 03/31/2020.
Infect Drug Resist
December 2024
Department of Orthopedics, Affiliated Hospital 6 of Nantong University, The Third People's Hospital of Yancheng, Yancheng, Jiangsu, People's Republic of China.
This report describes a case of lumbar disc infection potentially induced by acupuncture in a 43-year-old male with a history of back pain. After acupuncture treatment at another hospital, the patient experienced worsened pain. Physical examination revealed tenderness at the upper lumbar intervertebral space and paravertebral percussion pain.
View Article and Find Full Text PDFInt J Infect Dis
December 2024
Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Objectives: The aims of this study were 1) to investigate seasonal epidemiological variations of pyogenic spondylodiscitis, including Methicillin-resistant Staphylococcus aureus (MRSA) infection, in Japan, and 2) to evaluate associated inpatient outcomes.
Methods: We performed a retrospective nationwide study using data from the Japanese Diagnosis Procedure Combination (DPC) inpatient database, covering the period from 2010 to 2022. The parameters assessed were seasonal incidence, demographic characteristics, inpatient mortality, complications, and medical costs.
Cureus
November 2024
Physical Medicine and Rehabilitation, Hospital Curry Cabral, Unidade Local de Saúde de São José, Lisbon, PRT.
Introduction: Spondylodiscitis is a rare but increasingly infectious disease affecting the intervertebral discs and vertebrae.
Methods: This study retrospectively analyzed 36 patients admitted with spondylodiscitis over a five-year period, examining demographics, clinical features, risk factors, causative agents, treatment approaches, and outcomes.
Results: The patient cohort had a mean age of 53.
Infection
December 2024
Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Cologne, Germany.
Purpose: Patients with vertebral osteomyelitis (VO) and comorbidities, notably chronic kidney disease (CKD), are at risk of early mortality. The aim of this study was to compare characteristics and outcomes of VO patients with an underlying malignancy (ONCO) to VO patients with CKD and VO patients without comorbidities (CONTROL).
Methods: We performed a retrospective analysis of data which was prospectively collected between 2008 and 2020.
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