[Purulent arthritis of the spinal facet joint].

Purulent arthritis of the facet joint is a rare affection. It occurs most commonly by hematogenous spread of microorganisms and the initiating agent is in most cases Staphylococcus aureus. Diagnosis is made predominantly by means of MRI and hemocultures, or culture of pus aspirated from the abscess with a needle. Conservative therapy consists in a long-term administration of antibiotics. In case of insufficient response to the treatment or development of a neurological deficit, the patient is indicated for surgical revision, drainage and, if necessary, for decompression of nerve structures. In addition to sepsis, a severe complication of the purulent arthritis of the facet joint is propagation of the abscess epidurally, intradurally or foraminally with the risk of the onset of neurological deficit. In their case series the authors present four cases of purulent arthritis of the facet joint diagnosed and treated at the Department of Spinal Surgery of the University Hospital in Motol, Prague.