Spyropoulou Vasiliki, Valaikaite Raimunda, Dhouib Amira, Dayer Romain, Ceroni Dimitri
Pediatric Orthopedic Service, Geneva University Hospitals, 6 rue Willy-Donzé, 1211 Geneva 14, Switzerland.
Pediatric Radiology Service, Geneva University Hospitals, 6 rue Willy-Donzé, 1211 Geneva 14, Switzerland.
Case Rep Orthop. 2016;2016:8675761. doi: 10.1155/2016/8675761. Epub 2016 Feb 1.
Background Context. Computed tomography- (CT-) guided fine-needle aspiration biopsy of the vertebral body is an important tool in the diagnostic evaluation of vertebral osteomyelitis. The procedure is considered simple to perform and it is considered a safe procedure with few complications. Purpose. The purpose of this study was to describe an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, to better understand the relationship between surgical procedure and complication, and to reflect on how to avoid it. Study Design/Setting. Case report and literature review. Methods. The medical records, laboratory findings, and radiographic imaging studies of an 11-year-old boy, with an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, were reviewed. Results. We report a case of vertebral osteomyelitis of L3 caused by methicillin-sensitive Staphylococcus aureus (MSSA). Following a computed tomography-guided aspiration biopsy of the vertebral body of L3, vertebral osteomyelitis rapidly progressed into the vertebral body of L4 as well as the L3-L4 disk. Conclusions. Based on the present case, one should consider that a CT-guided fine-needle aspiration biopsy of the vertebral body may be complicated by a progression of a vertebral osteomyelitis into both the intervertebral disk and also the adjacent vertebral body.
背景信息。计算机断层扫描（CT）引导下的椎体细针穿刺活检是诊断椎体骨髓炎的重要工具。该操作被认为易于实施，且是一种并发症较少的安全操作。目的。本研究的目的是描述一例因L3椎体CT引导下细针穿刺活检导致的罕见并发症，以更好地理解手术操作与并发症之间的关系，并思考如何避免该并发症。研究设计/设置。病例报告及文献综述。方法。回顾了一名11岁男孩的病历、实验室检查结果及影像学研究，该男孩因L3椎体CT引导下细针穿刺活检出现罕见并发症。结果。我们报告一例由甲氧西林敏感金黄色葡萄球菌（MSSA）引起的L3椎体骨髓炎病例。在L3椎体CT引导下穿刺活检后，椎体骨髓炎迅速蔓延至L4椎体以及L3-L4椎间盘。结论。基于本病例，应考虑到CT引导下椎体细针穿刺活检可能会因椎体骨髓炎蔓延至椎间盘及相邻椎体而引发并发症。
