Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Discitis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed2004

Massive intracerebral air embolism associated with meningitis and lumbar spondylitis: case report.

BACKGROUND: Massive intracerebral air embolism is a rare pathologic state and never in association with meningitis and lumbar spondylitis. To the best of our knowledge, our presented case is the first of a massive intracerebral air embolism associated with meningitis and lumbar spondylitis of Klebsiella pneumonia. CASE DESCRIPTION: A 55-year-old man presented with a high fever and low back pain. Blood culture showed Klebsiella pneumonia. Lumbar computed tomography (CT) revealed discitis at L1-2 and L2-3 levels and paraspinal abscess in which air was found. Despite management with antibiotics, patient's consciousness deteriorated, and brain CT revealed diffuse intravenous air embolism and severe brain swelling. Cerebrospinal fluid (CSF) examination demonstrated bacterial meningitis, and the CSF culture showed Klebsiella pneumonia. Later, septic shock occurred and patient expired. CONCLUSION: Intracerebral air embolism can occur in the Klebsiella pneumonia meningitis that resulted from lumbar spondylitis and sepsis.

Cerebral Veins↗
PubMed1999

Malignancies in children who initially present with rheumatic complaints.

OBJECTIVE: Children ultimately diagnosed with malignancy are referred to pediatric rheumatology clinics with provisional rheumatic diagnoses. We aimed to distinguish the features in these patients that lead to the correct diagnosis of malignancy. STUDY DESIGN: A retrospective review of the case records of 29 children (19 boys and 10 girls, aged 1 to 15.5 years) with malignancy who were referred to 2 pediatric rheumatology centers between 1983 and 1997. RESULTS: The suspected diagnoses on referral were: juvenile rheumatoid arthritis (12), nonspecific connective tissue disease (4), discitis (3), spondyloarthropathy (3), systemic lupus erythematosus (2), Kawasaki disease (2), Lyme disease (1), mixed connective tissue disease (1), and dermatomyositis (1). The final diagnoses were leukemia (13), neuroblastoma (6), lymphoma (3), Ewing's sarcoma (3), ependymoma (1), thalamic glioma (1), epithelioma (1), and sarcoma (1). Patients had features typical of many rheumatic disorders including musculoskeletal pains (82%), fever (54%), fatigue (50%), weight loss (42%), hepatomegaly (29%), and arthritis (25%). Features that were suggestive of malignancy included nonarticular "bone" pain (68%), back pain as a major presenting feature (32%), bone tenderness (29%), severe constitutional symptoms (32%), clinical features "atypical" of most rheumatic disease (48%), and abnormal initial investigations (68%). The atypical features included night sweats (14%), ecchymoses and bruising (14%), abnormal neurologic signs (10%), abnormal masses (7%), and ptosis (3%). Initial investigations with abnormal findings included complete blood count/smear (31%), discordant erythrocyte sedimentation rate and platelet count (28%), elevated lactate dehydrognease level (24%), plain skeletal x-ray films (28%), bone scan (21%), and abdominal ultrasonography (17%). Findings of investigations done before referral to the rheumatology clinic were not recognized as abnormal in 11 (40%) patients. CONCLUSIONS: Patients with a diverse group of malignancies, other than leukemia, may present to the pediatric rheumatologist. Pediatric care providers should be familiar with typical features of childhood rheumatic disorders, and rheumatic diagnoses should be reevaluated in the presence of any atypical or discordant clinical features.

Adolescent↗
PubMed2004

[Technical features of endoscopic surgery for lumbar disc herniation: 191 patients].

BACKGROUND: We analyzed the contribution of endoscopic surgery for lumbar foraminal disc herniation in a series of 191 patients. METHODS: All the patients underwent a posterior paramedian endoscopic procedure performed by the same operator. This prospective study concerned 191 consecutive patients included between April 1999 and March 2002. Outcome was assessed with a self-administered questionnaire. Prolo's criteria were used. RESULTS: Of the 191 patients, 144 questionnaires (75%) were returned showing results were excellent in 130 (90%), good in 1 (0.7%) and poor in 13 (9%). The complications observed were: aseptic discitis (n=1); approach of two levels due to incorrect fluoroscopic guidance (n=2); dural tear (n=1); partial nerve root lesion (n=3); a second operation was necessary in 4 patients but only once at the same level and on the same side. Of the 80 patients who were working before the operation, 77 were able to return to work with an average delay of 3 weeks, 2 did not return to work and one worked only part time. CONCLUSIONS: These good results associated with a high rate of patient satisfaction demonstrate that endoscopic surgery is an effective technique for the foramen. Endoscopy allow complete exposure decompression of the nerve root all along the foraminal canal.

Adult↗
PubMed2004

Adopting 540-degree fusion to correct cervical kyphosis.

BACKGROUND: Two cases of severe cervical spine kyphotic deformity resulting from late effects of infection were successfully corrected by combined anterior and posterior instrumentations in a single operative sitting. CASE DESCRIPTION: Case 1 is a 43-year-old man who developed severe cervical kyphosis from C5-6 discitis over a few months despite long-term antibiotic therapy. He was neurologically intact except for severe neck pain and obvious deformity. Case 2 is a 40-year-old woman who had a previous wound infection five years before presentation. There was gradual worsening of swan neck deformity at the C2-3 and C5-6 levels with some spinal cord compression worsening her baseline myelopathy. The patients were placed and maintained in cervical traction on the Stryker frame for the duration of the procedure. Both cases required anterior approach initially to achieve some release of dense scar tissue using a high-speed drill. The wounds were then closed and patients were rotated to the prone position for further release of fused bony elements, including the facets. Lateral mass screws and plates were placed. In Case 2, additional instrument to the occipital was performed to stabilize the C2 using a U-shaped cervical rod. Once adequate reduction had been achieved, the patients were rotated back to supine position for further corpectomy and fibular construct fusion with plates. CONCLUSION: In cases of severe kyphotic deformity complicating infectious vertebral destruction, the spinal alignment can be achieved safely by a multi-step technique combining the anterior as well as posterior surgical approaches.

Adult↗
PubMed1998

Endoscopic transforaminal lumbar discectomy and reconfiguration: a postero-lateral approach into the spinal canal.

BACKGROUND: In the past, minimally invasive procedures (chemonucleolysis, laser, automated percutaneous discectomy, percutaneous manual nucleotomy, arthroscopy) have been largely confined to intradiscal work. This study represents cases of working channel, transforaminal spinal endoscopy performed using an endoscope which, because of its small size and flexibility, can bend up to 90 degrees (depending on the guiding cannula), and pass completely through the foramen into the spinal canal (truly transforaminal, as opposed to just going through part of the foramen and into the disc), to directly remove free fragments and reconfigure disc, relieving root and dural displacement at all lumbar levels. METHODS: The records of 533 patients who had outpatient, minimally invasive operations performed over a 6-year period (ending in 1995) by this author were analyzed. Of these, 110 had small scope transforaminal procedures, forming the basis of this study. RESULTS: An independent observer followed the 110 patients who had endoscopic transforaminal procedures for 2 or more years. Using MacNab's criteria, the success rate (excellent or good) was 95% in the 75 patients with disc presenting lateral to the dura-"lateral presenting,"-and 83% in the 35 patients not presenting disc for direct removal-"non-lateral presenting" (i.e., dura in the pathway)-making an overall success rate of 91%. One patient who developed discitis was the only complication. CONCLUSION: Guideable endoscopes small enough to pass completely through the foramen allow percutaneous surgery to include non-contained disc herniations and even some migrated free fragments, depending on the location. The percutaneous transforaminal endoscopic technique can be an effective, safe approach for disc removal through the foramen, especially in cases where the disc presents itself for direct removal.

Ambulatory Care↗
PubMed2003

Late infection of a total knee arthroplasty with Streptococcus bovis in association with carcinoma of the large intestine.

Infection of a total knee arthroplasty with Streptococcus bovis in a 76-year-old man that led to the diagnosis of a bowel carcinoma is reported. Investigation revealed a malignancy in the ascending colon with extension into the adrenal gland. S bovis in conjunction with colonic neoplasia has been reported in several orthopedic conditions: vertebral osteomyelitis, discitis, lateral neck abscess, and osteomyelitis of the ileum. The relationship of S bovis to endocarditis, meningitis, brain abscesses, and peritonitis has also been well described. However, S bovis is a rare pathogen infecting joint prostheses and should raise the possibility of a gastrointestinal lesion.

Adenocarcinoma, Clear Cell↗
PubMedDate not supplied

Automated percutaneous lumbar discectomy: a prospective multi-institutional study.

PURPOSE: A prospective study in 10 independent hospitals from 1992 to 1994 evaluated automated percutaneous lumbar discectomy (APLD) with a newly designed percutaneous instrument. MATERIALS AND METHODS: One thousand five hundred eighty-two APLD procedures were performed in 1,525 patients with disc herniation or back pain. Mean follow-up after APLD was 18.3 months. Follow-up of at least 1 year was available in 1,474 patients. One thousand two hundred eighty-nine patients had sciatic pain and 185 had back pain only. Eight hundred twenty-two patients had symptoms for less than 2 years, 652 for more than 2 years. One thousand two hundred sixty-two patients were older than 60 years, 212 were younger than 60 years. Nine hundred fifty patients had disc protrusion, and 357 had sequestration. Forty-eight patients had disc or longitudinal ligament calcification. Twenty-two had previous surgical discectomy. All discectomies were done with use of a straight needle with the patient in the lateral decubitus position. RESULTS: Success rate (measured by Hijikata's criteria) was 83% at 1 year. Success was significantly greater for protrusion versus sequestration (86% vs 72%, P < .001); for back pain alone versus leg and back pain (89% vs 80%, P < .005); for duration of symptoms less than 2 years versus more than 2 years (85% vs 79%, P < .005); and for age younger than 60 years versus older than 60 years (84% vs 76%, P < .01). Among postsurgical patients, success rate was 77% (17 of 22 patients). The only complication was discitis (0.06%, nine patients). Technical success at L5-S1 was 99% (795 of 800). CONCLUSION: APLD with Teng's instrument has excellent results. Indications may include back pain alone. A straight needle can be used at L5-S1 in most patients, with proper positioning.

Diskectomy, Percutaneous↗
PubMed2001

Limited magnetic resonance imaging in low back pain instead of plain radiographs: experience with first 1000 cases.

AIM: We report our experience with the first 1000 patients with non-traumatic low back pain (LBP) without radiculopathy undergoing limited sequence magnetic resonance imaging (MRI) instead of plain radiography. METHODS: Between January 1996 and December 1998, 1042 patients with low back pain unresponsive to conservative treatment were examined using a limited MR protocol comprising sagittal T1-weighted and STIR imaging. Plain radiographs were not performed. RESULTS: Malignancy, infection, vertebral fracture, spondylitis, pars defects and cord tumours were detected in 20%. Of the 82 osteoporotic vertebral fractures detected, 51 (62%) were recent and 31 had normal marrow signal indicating that they were old. Eighty pars defects were identified, 45(56%) had spondylolisthesis, 29(37%) were undisplaced and 6 (7%) had pars oedema only. Neoplastic disease was found in 17(8%) of which none was suspected before imaging. Benign neoplastic diseases such as vertebral AVM/haemangiomata were excluded. Twenty-one patients had a variety of disorders including ankylosing spondylitis (7), large vessel aneurysm (3), discitis (2), ovarian cyst (2), sequestered disc (2), sacral insufficiency fracture (2) and one patient each with burst fracture, retroperitoneal haematoma and a previously unsuspected horseshoe kidney. CONCLUSION: The majority of patients with LBP are best assessed clinically and imaging is usually not required. In patients with worrying symptoms, MRI with a limited protocol detects a greater number of abnormalities than previously reported studies using plain radiographs and has replaced plain radiography in our hospital. We report our experience with the first 1000 patients and highlight issues such as protocols, detection rates and communication issues.

Female↗
PubMed2002

MRI of the post-discectomy lumbar spine.

Laminectomy and discectomy are common procedures in the management of symptomatic lumbar disc herniation. Complications of such surgery include recurrent/residual disc herniation, epidural scar formation, discitis, arachnoiditis and pseudo-meningocele. Gadolinium-enhanced MRI is the technique of choice for investigating recurrent symptoms following discectomy. This article reviews the normal early and late post-laminectomy MR appearances, as well as the pathological findings associated with the above-mentioned complications.

Contrast Media↗
PubMed1975

[Complications of cervical discography (author's transl)].

The report deals with 1,005 discographic examinations in 380 patients with a cervical syndrome. Three cases of a discitis were observed, of which two had to be regarded as complications of the examination. The aetiology, clinical features, diagnosis and differential diagnosis are described: therapeutic and prophylactic problems and possible complications are discussed. With a complication rate of 0.2%, the authors recommend contrast demonstration of the cervical disc as a supplementary radiological method for the investigation of the cervical syndrome.

Brachial Plexus Neuritis↗
PubMed1979

[Comments on the problem of non-specific sclerosing spondylodiscitides (author's transl)].

After reviewing types of sclerosis of the vertebral bodies and spondylodiscitides occurring near the vertebral discs, the causes of which are relatively well known, two observations of cases of chronic progressive sclerosing spondylodiscitis are described in detail together with their case history. The primary manifestation (in the lumbar vertebral column) is seen, apart from a discitis, in a relatively early and eventually homogeneous sclerosing of the spongiosa. The course of the disease is extremely protracted; after 1-5 years, other parts of the vertebral column are affected in a similar manner. Inflammatory parameters are definitely involved, and the nosological neighbourhood to angylosing spondylitis is discussed. In the absence of any other hints, it appears justified to assume non-specific chronic progressive sclerosing spondylodiscitis which begins monostotically and can proceed according to a polystotic pattern.

Adult↗
PubMedDate not supplied

[Infectious damage to the intervertebral disk--before and following discotomy].

Bad results after discotomy for treatment of herniated lumbar disc are caused either by postoperative complications or by preoperative diagnostic errors. Very often other degenerative changes of the "Bewegungssegment" are involved and misunderstood. But also septic lesions of the intervertebral disc following pyogenic hematogenous osteomyelitis of the spine are confused with degenerative lesions. They are even treated operatively as a ruptured intervertebral disc. When pyogenic osteomyelitis may no longer by overlooked after discotomy due to her progression, she is misinterpreted as discitis following removal of intervertebral disc. Only 9 of 97 verified patients with vertebral osteomyelitis suffered from true postoperative infection of the intervertebral space after removal of a herniated disc. In 14 patients the signs of hematogenous osteomyelitis of the spine have been missed or have been explained by degenerative changes of the spine. In none of the patients the wrong diagnosis was perioperatively revised. The common confusion of osteomyelitis and degenerative disc changes can be explained by several reasons: the predilection of lumbar spine and the similarity of local signs of both diseases, the unknown or underestimated frequence of radicular lesions in osteomyelitis of the spine and the difficulties to assess osteomyelitis in early stages by X-ray examination and the frequency of accessory degenerative changes. It may be supposed that many of the reported disc space inflammations after diagnostic or therapeutic means have not been caused by these manipulations but have given occasion for them.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Changes in the cervical spine in chronic polyarthritis].

In 93 patients with classical chronic polyarthritis (rheumatoid arthritis) (at least five ARA-criterias) there were inflammatory lesions of dens epistropheus in 48.4%, ventral atlantoaxial subluxations in 25.8%, lateral atlantoaxial dislocations in 14% and pseudobasilary invagination in 5.4%. Step-ladder-subluxation between C 2/C 7 was found in 31.2%, discitis in 12.5% and spondylarthritis in 38% of cases. Inflammatory signs of the cervical spine were correlated to the Steinbrocker-Grade IV, ANA level 1:40 and the degree of Waaler-Rose. The correlation between long standing steroid-therapy and signs of cervical involvement during c.p.--specially in C1/C2--is found to be proven. There are connections between the duration of c.p. (more than 10 years) and manifestation of cervical spine lesions, further, in a protective sense between longstanding gold therapy and cervical spine lesions.

Adult↗
PubMed1999

A special device for endoscopic surgery of lumbar disc herniation.

We studied the use of an endoscopic technique for lumbar discectomy, the most frequent operation in spinal surgery. Minimal invasive procedures are cost effective and allow earlier resumption of activities, work and sports. Endoscopic procedures have become more frequent in surgery but rarely for spinal surgery. It is sometimes used in the disc itself but not in the spinal canal. The goal of this operation is to reach the disc herniation in the spinal canal through a small incision, using a special device with an endoscope. It is composed of three tubes: one for the endoscope, one for aspiration and the largest one for classical surgical instruments. A protected space is created at one end of the tubes by a special part of the device which looks like a speculum; there is also an included nerve retractor. One hundred patients were operated during the year 1993. In a follow-up, 91 patients were evaluated using Prolo's criteria. The results could be classified as excellent in 78 patients, good in nine and poor in four. Complications were rare: two discitis, four recurrences, one failure. This technique allows a smaller incision, less trauma to lumbar muscles, better identification of deep structures, soft manipulation and better release of neural structures, perfect hemostasis and no drain. Early post-operative mobilization is easy and special wound dressing allows immediate shower and intensive re-education. These excellent results must be confirmed by long term studies; nevertheless this minimal invasive technique can be considered as a safe and effective treatment of the lumbar disc herniation.

Adult↗
PubMed2001

Review of safety in endoscopic laser foraminoplasty for the management of back pain.

OBJECTIVE: The purpose of this study was to analyze the incidence and gravity of reported complications that arise in spinal surgery and assess the comparative safety, or otherwise, of endoscopic laser foraminoplasty (ELF). BACKGROUND DATA: Chemonucleolysis, decompression, discectomy, and fusion have long been cited as treatments for chronic low back pain. Over recent years newer, less invasive surgical techniques have become available, one such being ELF. Although minimally invasive, the beneficial outcome must be interpreted in relation to concerns regarding the safety of the procedure and its risks relative to those of other forms of spinal surgery. The Spinal Foundation, Rochdale has performed 958 ELFs and has collated a comprehensive database of the results of all these operations. These prospective records provided the basis for a comparison of the safety of ELF to that reported with other spinal surgical techniques. METHODS: A total of 958 procedures have been performed on 716 patients. Complications that arose during the operation and the postoperative phase of 6 weeks following the procedure were elicited from patient records. These data were correlated and compared to a meta-analysis of randomized controlled clinical trial data of complications arising during and after conventional spinal surgery. The SPSS (statistical package for social sciences) and CIA (confidence interval analysis) statistical packages were used to draw conclusions regarding the safety of ELF. RESULTS: The cohort integrity of operation and outpatient review records at 6 weeks after surgery was 100%. In 958 ELFs performed, 24 complications occurred in 23 patients. There were 9 cases of discitis (1 infective, 8 aseptic) (0.9%), 1 dural tear (0.1%), 1 deep wound infection (0.1%), 2 patients suffered a foot drop (1 transient) (0.2%), 1 myocardial infarction (0.1%), 1 erectile dysfunction (0.1%), and 1 patient who developed panic attacks post-operatively (0.1%). This amounts to an overall surgical complication rate of 1.6%. Magnetic resonance imaging (MRI) follow up of clinically symptomatic patients highlighted 8 residual disc herniations (0.8%). Meta-analysis of randomized controlled trials of conventional spinal surgery for adult onset degenerative disc disease and/or sciatic pain reported overall complication rates for fusion (11.8%), decompression (7.6%), discectomy (6.0%), and chemonucleolysis (9.6%). CONCLUSIONS: The complication rate of ELF is shown to be significantly lower than that reported following conventional spinal surgery (p < 0.01). From these results, we conclude that ELF as a treatment for chronic low back pain and sciatica presents less risk to a patient than conventional methods of spinal surgery.

Chronic Disease↗
PubMed1979

Spinal mobility in the adolescent.

The ranges of spinal movement in 390 healthy children aged from 10 to 15 years have been recorded. These measurements are in two planes, anterior and lateral; they are quick and easy to perform and require no special equipment, just a tape measure. Many conditions occurring in childhood can lead to limitation of spinal movement: these include juvenile ankylosing spondylitis, spondylolisthesis, Scheuermann's vertebral osteochondritis, discitis and vertebral fractures, the latter being not uncommon in children receiving prolonged corticosteroid therapy. The purpose of the present paper is to define the normal range for anterior and lateral spinal flexion in adolescents and to correlate these with sex, age, height and weight.

Adolescent↗
PubMed1987

Spinal brucellosis.

The findings in 44 patients with back pain and brucellosis are described. Radiological changes tended to occur in older patients with a longer duration of disease. The younger patients more often experienced an acute arthritis with sacroiliitis resembling a reactive disease. Bone scanning was more sensitive than radiographs, particularly in detecting acute sacroiliitis and hip involvement. The lumbar spine was the most frequently involved site although no part of the spine was spared. Extensive destruction of a vertebral body with little involvement of the adjacent vertebrae, lower lumbar spondylolysis and spondylolisthesis, and discitis with calcification were striking radiological findings hitherto undescribed in brucellosis. Computerized axial tomography (CAT) scanning revealed vertebral-arch destruction in three cases of spondylolisthesis. Circumferential sclerosis of the vertebral bodies was another CAT-scan finding.

Adult↗
PubMed2001

Rheumatic manifestations of infective endocarditis in non-addicts. A 12-year study.

Infective endocarditis (IE) is due to a microbial infection of the heart valves or of the endocardium in close proximity to either congenital or acquired cardiac defects. This infection is associated with a high risk of complications. Rheumatic manifestations are known to be frequent complications of IE. Controversy, however, frequently exists about the actual incidence of these complications. This may be due to the small number of series describing the frequency and type of rheumatic manifestations, the absence of uniform criteria used for the diagnosis of IE, and the fact that some studies on rheumatic manifestations in IE have been described from tertiary referral centers, which implicates associated problems of referral bias and uncertainty of denominator population. To investigate further the incidence, clinical spectrum, and outcome of patients with IE and rheumatic manifestations, we examined the features of patients diagnosed with clinically definite IE according to the Duke classification criteria at the single reference hospital for a defined population in northwestern Spain during a 12-year period. Between 1987 and 1998, 100 consecutive patients had 110 episodes of clinically definite IE. Rheumatic manifestations were observed in 46 of the 110 episodes (41.8%). As in other western countries, they occurred more commonly in men aged in their 50s. The most frequent valve involved was the aortic (43.5%) followed by the mitral valve (30.4%). Myalgia was a frequent symptom. Peripheral arthritis, generally as monoarthritis, was clinically evident in 15 cases (13.6%), and sacroiliitis in 1 patient. Low back pain was described in 14 cases (12.7%). Septic discitis was observed in 2 cases, and biopsy-proved cutaneous leukocytoclastic vasculitis was found in 4 cases. Other conditions such as trochanteric bursitis and polymyalgia were observed in 2 and 1 case, respectively. Apart from a significantly higher frequency of hematuria and a trend to lower serum complement levels in patients with rheumatic complications, no differences in clinical features, laboratory tests, or microbiologic blood culture results were found between cases with IE with or without rheumatic manifestations. Also, although patients with rheumatic manifestations had more embolic complications, the inhospital mortality rate in patients with rheumatic manifestations was not significantly different from that of the rest of the patients. The present study supports the claim that rheumatic complications are frequent in patients with clinically definite IE from southern Europe. The presence of musculoskeletal or vasculitic manifestations may be of some help, as warning signs, for the recognition of patients with severe disease who require rapid diagnosis and therapy.

Adolescent↗