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At least 1,027 records · Page 57Linked to original sources
PubMed2006

A modified vertebroplasty approach for spine biopsies.

There are various techniques available for percutaneous biopsy of suspected diskitis/osteomyelitis. Our technique has evolved as our experience with percutaneous vertebroplasty has grown. By using a transpedicular approach, we angle a bone biopsy needle in an exaggerated caudocranial trajectory to allow eventual access across the disk space above. This approach permits sampling of the disk space, as well as both adjacent vertebral endplates. We describe our percutaneous modified vertebroplasty approach for biopsy of suspected diskitis/osteomyelitis.

Aged↗
PubMed2006

[Infectious spondylodiscitis: the surgical approach].

Introduction of antibiotics in the last century and recent progress in surgical techniques have significantly reduced mortality and morbidity rates of spondylodiscitis. However, when unrecognized, it can have catastrophic consequences for the patient. Antibiotic drugs remain the cornerstone of treatment, and surgery is to be discussed in general as a last resource in case of acute neurologic deficit or severe sagittal or frontal spinal imbalance. Metallic implants are not absolutely contraindicated in surgical treatment of spondylodiscitis and relapse of infection has been reported to be rare. In case of severe mechanical instability and neurologic deficit, they even are indispensable and complications can be avoided by accurately identifying the germ and by treating infection with the adequate antibiotic beforehand.

Anti-Bacterial Agents↗
PubMed2006

[Infectious spondylodiscitis: the rheumatologist's point of view].

Infectious spondylodiscitis is increasingly prevalent in the elderly population. Despite modern imagery techniques, time between onset of symptoms and diagnosis is still important and directly affects mortality rate. The systematic use of red flags for back pain patients should be able to improve this situation. In case of clinical and radiological suspicion of infectious spondylodiscitis, every effort should be directed toward the characterization of the bacteria before the introduction of antibiotics. Most of the time conservative treatment with antibiotics and bracing is appropriate but in selected cases a surgical procedure is advised, specifically in case of severe motor deficit or in the presence of non-tuberculosis abscess.

Discitis↗
PubMed2005

Streptococcus suis meningitis with ventriculoperitoneal shunt infection and spondylodiscitis.

Streptococcus suis is a zoonotic pathogen which causes meningitis, bacteremia, and endocarditis in pigs. Human infection is rare and often presents as meningitis with the sequela of permanent deafness and endocarditis. Previous cases were reported from pig-rearing countries such as Holland and Hong Kong. We report a 55-year-old bedridden man with S. suis meningitis complicated with ventriculoperitoneal shunt infection and lumbar spine spondylodiscitis. He presented with fever, delirium, neck stiffness, lower leg weakness and sudden onset hearing loss for several days. He was successfully treated with intravenous antibiotics, ventriculoperitoneal shunt replacement, lumbar spinal laminotomy and discectomy. Cerebrospinal fluid culture initially misidentified the organism as Streptococcus acidominimus, and S. suis was later identified by 16S rRNA sequencing. Misidentification of the microbiological findings may lead to a failure to correctly diagnose this disease. S. suis meningitis should be included in the differential diagnosis of patients with meningitis and sudden hearing loss.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Idiopathic intervertebral disc calcification in children: the role of diagnostic imaging. A case report].

The idiopathic calcification of the intervertebral disc in childhood is a rare syndrome with unknown aetiology. This pathology is more frequent in males, with predominant localization to cervical spine. The natural evolution of the syndrome is the progressive and spontaneous resorption of the calcific deposit, with symptom regression. We report a case of an acute and worsening torticollis in a 10-year-old child, with reference to a recent minor cervical distortion, resistant to analgesic treatment. X-ray evaluation, executed after a week from the appearance of torticollis, showed an oval calcification in the nucleus pulposus of the C6-C7 intervertebral disc. The CT and especially the MRI concurred to recognize a disc hernia and an adjacent osteo-ligamentous pathologic participation. In particular, MRI showed the adjacent vertebral spongy bone edema and the active enthesiopathy of the posterior longitudinal ligament.

Calcinosis↗
PubMed2006

The role of radioisotopic methods in imaging of intervertebral disc inflammation in children.

The authors present the case of a 17-year-old girl, with pain over lumbar spine area, treated by paediatricians and rehabilitation specialists, discussing diagnostic imaging and laboratory examinations together with clinical observations. Spondylodiscitis was diagnosed after bone scintigraphy with 99mTc-MDP, the course of disease was monitored by immunoscintigraphy amongst other techniques.

Adolescent↗
PubMed2006

Nosocomial spondylodiskitis with epidural abscess and CSF fistula cured with quinupristin/dalfopristin and linezolid.

Nosocomial infections after spinal surgery are relatively uncommon but potentially serious. The goal of diagnostic evaluation is to determine the extent of infection and identify the microorganism involved. Neuroimaging provides accurate information on correct topography, localization and propagation of the infection. Microbiological data are able to give aetiological causes. In this patient with severe, chronic polymicrobial spine infection with epidural abscess and CSF fistula due to multidrug-resistant organisms, the cure was achieved with long-term antimicrobial specific therapy with quinupristin-dalfopristin (50 days) and linezolid (100 days) with mild side effects. This positive result was due to combined medical and surgical treatment.

Acetamides↗
PubMed2006

A rare cause of flank mass: psoas abscess due to extensive primary thoracolumbar tuberculous spondylodiskitis.

Psoas abscess secondary to tuberculous spondylodiskitis is usually a complication of thoracolumbar vertebrae disease. The psoas abscess may be difficult clinically to diagnose because of its rarity, insidious onset of the disease, and nonspecific clinical presentation. We report multidetector CT and MR imaging findings of a psoas abscess secondary to primary tuberculous spondylodiskitis of the spine from the T3 to L2 vertebrae, which presented as a flank mass.

Adult↗
PubMed2006

[Candida spondylodiscitis and epidural abscess].

Candida spondylodiscitis associatd with epidural abscess is rarely seen. We present a patient with Hodgkin lymphoma who received chemotherapy and developed systemic Candida infection, which was complicated by Candida spondylodiscitis and epidural abscess.

Antifungal Agents↗
PubMed2006

Diskography: infectious complications from a series of 12,634 cases.

BACKGROUND AND PURPOSE: Diskography is commonly performed to investigate pain of suspected diskogenic origin. Although uncommon, diskitis is a feared complication of this procedure. We reviewed the incidence of diskitis and other infectious complications following diskography in a large busy outpatient practice and discuss technical aspects that may contribute to infection prevention. METHODS: We reviewed the electronic records of all diskograms obtained at our institution during a 12.25-year period, looking for all cases of procedure-related infection. All diskograms had been obtained by skilled and experienced procedural radiologists in dedicated spine-injection suites with specialized technical staff. RESULTS: There were 12,634 examinations performed on 10,663 patients for a total of 37,135 disk levels. Of the disk levels, 5981 were cervical; 3083, thoracic; and 28,071, lumbar. Two cases of confirmed lumbar diskitis and no cases of either cervical or thoracic diskitis were seen in our series. No other infectious complications were found. The incidence of diskitis was 0.016% per examination and 0.0054% per disk level. CONCLUSION: In skilled and experienced hands using proper technique, diskography is a safe outpatient procedure with an extremely low incidence of diskitis and other procedure-related infections.

Adolescent↗
PubMed1991

[The contribution of gadolinium to the magnetic resonance diagnosis of spondylodiscitis].

To determine the contribution of Gd-DTPA to the evaluation of vertebral infections 16 MR examinations with i.v. Gd-DTPA injection were performed on 12 patients with diagnosis of spondylodiscitis. All patients were examined with both SE T1- and SE T2-weighted sequences. The SE T1-weighted sequence was repeated following i.v. Gd-DTPA injection (0.1 nmol/kg). Signal intensities and visibility of the lesions were evaluated with MR. For each lesion the grade of visibility on SE T1-weighted sequence was compared with the grade of visibility on SE T2-weighted sequence. Moreover, for each study the information obtained by the combined evaluation of SE T1-weighted sequence without and with Gd-DTPA was compared with the information obtained by combined SE T1- and SE T2-weighted sequences. Gd-DTPA was useful in the evaluation of lesions of the discal space, showing in all cases an area of low signal intensity with peripheral enhancement; this finding allowed, in some cases, to differentiate mild spondylodiscitis from degenerative features. Gd-DTPA was also very useful in determining the extent of the disease: in comparison with MR study without contrast media, the combined evaluation of SE T1-weighted sequence without and with Gd-DTPA better showed the extent of the disease in 7/8 cases (88%).

Adult↗
PubMed1991

[Role of iatrogenic spondylodiscitis among pyogenic spondylodiscitis. 136 cases observed between 1980 and 1989].

The authors report 136 cases of spondylodiscitis due to ordinary organisms seen between 1980 and 1989 and note the increasing incidence of iatrogenic forms which during the past three years accounted for 50 per cent of cases. 60 per cent of these cases of iatrogenic spondylodiscitis complicated a medical of surgical procedure involving the spine (form by direct inoculation). In 40 per cent of cases, the organism came from a site of infection located at a distance (from by blood-borne spread). The clinical picture in cases of primary spondylodiscitis and of iatrogenic disease by blood-borne spread is essentially similar. That of iatrogenic forms by direct inoculation is different: most often young subjects, virtually exclusive involvement of the lumbar spine, fever and inflammatory syndrome less common. Escherichia coli and Staphylococcus aureus were the organisms most often responsible for primary spondylodiscitis (23 and 21.7 per cent of case respectively). Streptococci were in third position only (15.6 per cent of cases). Staphylococcus aureus remained predominant in iatrogenic spondylodiscitis (34 per cent of cases), while Escherichia coli and streptococci were significantly rarer than in primary forms and there was the appearance of Pseudomonas aeruginosa and Staphylococcus albus. No organism was found in 23 per cent of cases of primary spondylodiscitis. This figure reached 44% of iatrogenic forms by direct inoculation. Because of their increasing incidence, these cases of apparently aseptic spondylodiscitis, frequently complicating a procedure involving the spine, are modifying the picture of infectious spondylodiscitis. No doubt worthy of separate identification, they raise the problem of the significance of the concept of aseptic spondylodiscitis.

Adolescent↗
PubMedDate not supplied

[Non-specific spondylodiscitis in children: report of a case in an infant. Review of the literature].

A case of non-specific spondylitis in an infant has prompted us to an ample review of the literature. The disease is acknowledged as characteristically benign in children. However some publications seem to imply that in the very young child it would display a remarkable seriousness. From our case and half a score of others that we found in the literature, it appears that in the first year of life the nonspecific spondylitis has the same features as in the older children, namely a mild course and a good prognosis. The above publications probably refer to peculiar cases, which give rise to an as yet unsolved nosological problem. The characteristics of the disease, with special emphasis on its clinical and radiological presentation and evolution, are exposed.

Diagnosis, Differential↗