Dhodapkar Meera, Rosenow Christian, Mechas Charles-Antoine, Freedman Brett
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
J Neurosurg Case Lessons. 2025 Sep 15;10(11). doi: 10.3171/CASE25220.
Septic facet cysts are a rare phenomenon reported in the literature among immunocompromised hosts and may require operative intervention for appropriate source and symptomatic control.
A 70-year-old male with a past medical history of immunoglobulin A lambda smoldering myeloma degenerative lumbar disease who presented with low back and radicular lower extremity pain was found to have a left L4-5 septic facet cyst with extension to the epidural space. Intraoperative cultures were positive for Nocardia species. Staging workup revealed progression to high-risk-profile multiple myeloma.
Patients with septic facet cysts may require operative intervention for appropriate source control. Nocardia spine infections and septic facet cysts are rare and require investigation of preexisting risk factors and any potential underlying immunocompromise. https://thejns.org/doi/10.3171/CASE25220.
化脓性小关节囊肿是文献中报道的免疫功能低下宿主中罕见的现象，可能需要手术干预以进行适当的感染源控制和症状控制。
一名70岁男性，有免疫球蛋白Aλ冒烟型骨髓瘤、退行性腰椎疾病病史，因腰背痛和下肢放射性疼痛就诊，发现有一个左L4-5化脓性小关节囊肿并延伸至硬膜外间隙。术中培养结果显示诺卡菌属阳性。分期检查显示已进展为高危型多发性骨髓瘤。
化脓性小关节囊肿患者可能需要手术干预以进行适当的感染源控制。诺卡菌脊柱感染和化脓性小关节囊肿很罕见，需要调查既往存在的危险因素和任何潜在的免疫功能低下情况。https://thejns.org/doi/10.3171/CASE25220 。
