Farah K, Graillon T, Dufour H, Fuentes S
Department of neurosurgery, Aix-Marseille university, Timone hospital, 264, rue Saint-Pierre, 13385 Marseille, France.
Department of neurosurgery, Aix-Marseille university, Timone hospital, 264, rue Saint-Pierre, 13385 Marseille, France.
Neurochirurgie. 2018 Mar;64(1):53-56. doi: 10.1016/j.neuchi.2017.09.003. Epub 2018 Feb 13.
Adjacent level spondylodiscitis (ALS) after primary surgery for thoracic spondylodiscitis is a very rare condition.
We report the case of a 76-year-old man with this pathology. A first posterior minimally invasive approach combined with anterior approach to the thoracic spine was safely performed for thoracic spondylodiscitis. More than a year later, exploration of recurrent symptoms with FDG PET scan helped to diagnose ALS. Further surgery was performed. At 3-year follow-up examination showed no recurrence of the infection.
ALS should be suspected during recurrent symptoms after spinal fusion surgery. Evaluation should be based on the results of FDG PET scan and surgery.
Bacterial and histopathological analyses combined with an increase of spine fixation and adapted antimicrobial therapy are a safe management for ALS.
胸椎感染性椎间盘炎初次手术后发生的相邻节段感染性椎间盘炎（ALS）是一种非常罕见的病症。
我们报告了一名患有这种病症的76岁男性病例。针对胸椎感染性椎间盘炎，安全地实施了首次后路微创入路联合前路胸椎入路手术。一年多后，通过氟脱氧葡萄糖正电子发射断层扫描（FDG PET）检查复发性症状，有助于诊断ALS。随后进行了进一步手术。在3年的随访检查中未显示感染复发。
脊柱融合手术后出现复发性症状时应怀疑ALS。评估应基于FDG PET扫描结果和手术情况。
细菌和组织病理学分析，结合增加脊柱固定及采用适当的抗菌治疗，是ALS的安全管理方法。
