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Extensive discovertebral lesion is an infrequent complication of long-standing ankylosing spondylitis. Reported histopathological descriptions vary from predominantly inflammatory to fibrous granulation with reactive bone formation. We report variable histological findings in four symptomatic patients with extensive discovertebral lesions who required spinal fusion.
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We report a new case of spondylodiscitis due to Kingella kingae in a 19-month-old infant who had torticollis as the first manifestation. The main characteristics of Kingella kingae infections are reviewed: frequency of ENT and joint localizations, slow course, difficult clinical and bacteriological diagnosis, and satisfactory susceptibility to antimicrobial agents.
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We report 2 cases of intrathoracic sarcoidosis associated with tuberculous spondylitis. Although such cases are exceptional, one cannot help wondering whether or not sarcoidosis and tuberculosis are interrelated.
Nonspecific spondylodiscitis at the child age represents a distinctive disease of intervertebral disc and adjacent subchondral parts of vertebral bodies. Their early diagnostics may be difficult due to latency of radiographic manifestation of the finding and possible mistaking for other pathological conditions, especially tuberculosis spondylitis. The paper demonstrates several cases of the disease which we encountered recently. The authors discuss clinical and X-ray symptoms of the disease with a particular attention to modern methods of visualization, especially computer tomography. Etiopathogenesis of the disease is analyzed and some new knowledge of the disease is presented, differential diagnosis is discussed. In the conclusion attention is paid to early diagnosis of the disease and introduction of proper therapy.
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Long-term outcome and therapy are reported in 29 patients with vertebral osteomyelitis. Antibiotics were administered for a mean period of 21 (6-102) weeks. In 13 patients surgery was additionally necessary. After a mean follow-up of 53 (10-136) months only one relapse had occurred. Radiographs and erythrocyte sedimentation rate were the best indicators of successful treatment.
Scintigraphic scanning of the lumbar spine skeleton was performed in 9 patients with spondylodiscitis following an operation for the herniation of a lumbar intervertebral disk. The difference in scintigraphic findings demonstrates the valuable diagnostic contribution of this examination to an early diagnosis of postoperative spondylodiscitis.
19 patients diagnosed as non-tuberculous infectious spondylodiscitis (NTIS) have been studied retrospectively over the last 10 years in three general hospitals. The etiology of 13 cases was confirmed (there were nine cases of Staphylococcus aureus, two of Brucella, one of Pseudomonas aeruginosa and another of Salmonella typhi), and the diagnosis of the remaining cases was based on clinical and radiological data as well as on the evolution with antibiotic treatment. The age of the majority of these patients ranged between 40 and 60 years (p less than 0.05), showing a clear predominance of males (p less than 0.05). The most frequently appearing symptom at the beginning of the disease was local pain which was observed in nine patients; the rest presented mixed symptoms which led to misdiagnosis at admission; an exploratory laparotomy was carried out in one patient. The interval from the symptoms' onset to diagnosis ranged between two and sixteen weeks, with an average of 6.8 weeks. The VSG had values between 22 and 148 mm during the first hour, with an average of 83.3 mm. Seven patients underwent surgery, six of them presenting paraparesis-paraplegia, while another presented cervical spondylodiscitis. One patient passed away, two persisted with paraparesis-paraplegia as an irreversible sequela and one with persistent local pain.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The authors report a case of infectious spondylodiscitis revealing a staphylococcal endocarditis in a patient with a Carpentier aortic heterograft. This case, along with 60 descriptions from the literature, has enabled them to specify the characteristics of occurrence of endocarditis during a spondylodiscitis. The clinical factors in favor of this association are: a pre-existing cardiopathy, an oral port of entry, occurrence of other rheumatoid manifestations, even more the presence of complications of endocarditis. The laboratory factors in favor of an association are: discovery of an inflammatory anemia, of circulating immune complexes, of a cryoglobulinemia, of a rheumatoid factor, of hematuria. But it is mostly the demonstration of streptococcus in blood cultures and other samples that should be an indication to search for an endocarditis, the course of which dominates the prognosis.
The syndrome encompassing failed back-surgery is a relatively uniform combination of complaints caused by a variety of pathological changes in the lumbar spine, alone or in various combinations. The MRI's capability of detecting these factors is described. MRI can detect recurrent disc herniations and separate them from intradural and/or extradural scar formation. With further experience, MRI might also be able to assess instability of the lumbar spine motion segments. MRI is not very helpful in detecting neural lesions or facette syndromes. For this kind of pathology, advances in diagnosis will depend on the further improvement of neuro- and electrophysiological tests. The same applies to the diagnosis of cases of spinal stenosis. The size of the spinal canal can be measured by MRI as well as by other modalities. These results just point out the risk of disease - not the disease itself.