Topolovec Matevž, Faganeli Nataša, Brumat Peter
Department of Spine Surgery, Valdoltra Orthopaedic Hospital, Ankaran, Slovenia.
Faculty of Medicine, University of Maribor, Maribor, Slovenia.
Front Surg. 2022 Oct 4;9:998011. doi: 10.3389/fsurg.2022.998011. eCollection 2022.
Spondylodiscitis with/without neurologic impairment is a serious infection, predominantly occurring in high-risk patients. caused spondylodiscitis is very rare. Evidence-based therapeutic concepts for lumbar spondylodiscitis are lacking. A 64-year-old high-risk woman underwent decompression with instrumented lumbar fusion. Six months after index surgery, she developed pyelonephritis, which deteriorated to sepsis and presentation of cauda equina syndrome. She underwent urgent revision with decompression, debridement, and instrumentation removal, and received long-term antibiotics. Culture grew , previously not reported as a cause of spondylodiscitis after elective instrumented lumbar fusion. Emergent debridement and removal of instrumentation, with 2 months of targeted intravenous antibiotics followed by 6 weeks of oral antibiotics led to complete spondylodiscitis resolution. Prompt diagnostics and targeted antibiotic treatment are paramount when dealing with spinal infections, particularly in patients with rare causative pathogens like . Concomitant neurological complications may require emergent surgical management in the case of cauda equina syndrome.
伴或不伴神经功能损害的脊椎椎间盘炎是一种严重感染，主要发生在高危患者中。由 引起的脊椎椎间盘炎非常罕见。目前缺乏针对腰椎脊椎椎间盘炎的循证治疗理念。一名64岁的高危女性接受了减压并进行了腰椎器械融合术。初次手术后6个月，她发生了肾盂肾炎，病情恶化为脓毒症并出现马尾综合征。她接受了紧急翻修手术，包括减压、清创和取出内固定器械，并接受了长期抗生素治疗。培养结果显示 ，此前未报道其为选择性腰椎器械融合术后脊椎椎间盘炎的病因。紧急清创和取出内固定器械，静脉注射针对性抗生素2个月，随后口服抗生素6周，使脊椎椎间盘炎完全消退。在处理脊柱感染时，尤其是对于像 这样由罕见病原体引起感染的患者，及时诊断和针对性抗生素治疗至关重要。对于马尾综合征患者，伴随的神经并发症可能需要紧急手术治疗。
