Rajjoub Rami, Dedhia Mehek, Jones Salazar
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York.
J Neurosurg Case Lessons. 2024 Sep 9;8(11). doi: 10.3171/CASE24434.
Emphysematous osteomyelitis (EO) is a rare, rapidly progressing infection characterized by gas within bones, leading to severe morbidity if untreated. In the spine, EO can cause significant bone destruction and instability, requiring urgent surgical and medical intervention. Early diagnosis and a multidisciplinary approach are crucial for effective management and improved patient outcomes.
The authors present a unique case of EO involving the lumbar spine in a 40-year-old male patient with a medical history of diabetes mellitus, hyperlipidemia, and hypertension. Magnetic resonance imaging and computed tomography revealed the formation of gas within the L4 vertebral body and spinal canal, which led to the diagnosis of EO. Blood cultures grew Streptococcus dysgalactiae. The patient underwent laminectomy, discectomy, and vertebral body abscess washout to prevent further spread of the infection and successfully recovered.
The authors report the first case of spinal EO caused by S. dysgalactiae, treated using laminectomy with debridement of the affected disc spaces. https://thejns.org/doi/10.3171/CASE24434.
气性骨髓炎（EO）是一种罕见的、进展迅速的感染，其特征为骨内出现气体，若不治疗会导致严重的发病情况。在脊柱中，EO可导致显著的骨质破坏和不稳定，需要紧急的手术和药物干预。早期诊断和多学科方法对于有效管理和改善患者预后至关重要。
作者报告了一例独特的气性骨髓炎病例，累及一名40岁男性患者的腰椎，该患者有糖尿病、高脂血症和高血压病史。磁共振成像和计算机断层扫描显示L4椎体和椎管内有气体形成，从而诊断为气性骨髓炎。血培养培养出了停乳链球菌。患者接受了椎板切除术、椎间盘切除术和椎体脓肿冲洗，以防止感染进一步扩散，并成功康复。
作者报告了首例由停乳链球菌引起的脊柱气性骨髓炎病例，采用椎板切除术并对受累椎间盘间隙进行清创治疗。https://thejns.org/doi/10.3171/CASE24434 。
