Discitis
Diskectomy, Percutaneous
Intervertebral Disc
Epidural Abscess
Lumbar Vertebrae
Radiography
Tuberculosis, Spinal
Cefazolin
Osteomyelitis
Cervical Vertebrae
Thoracic Vertebrae
Diskectomy
Bone scintigraphy in tuberculous spondylodiscitis. (1/163)
Tuberculous affection of the spine can present in different ways. Plain radiographs may fail to show any abnormality. Bone scintigraphy can be a very useful tool in the diagnosis and management of patients with tuberculous spondylodiscitis. This is a retrospective study of 40 patients in whom bone scan was performed using 99mTc-MDP (technetium methylene diphosphonate) before starting anti-tuberculous therapy or any surgical intervention. Four different types of uptake were noted. The uptake was abnormal in 38 out of 40 patients, giving a sensitivity of 95%. Multicentricity was picked up in 25% of cases. No skull lesion was noticed in any of these patients. Rib lesions were found in six patients (ten ribs affected). The rib lesion was always a typical band pattern. This paper outlines the advantages as well as limitations of bone scan in tuberculous affection of the spine. (+info)Postoperative spondylodiskitis: etiology, clinical findings, prognosis, and comparison with nonoperative pyogenic spondylodiskitis. (2/163)
We studied 31 cases of postoperative pyogenic spondylodiskitis (POS), comparing them with 72 cases of nonpostoperative pyogenic spondylodiskitis (NPOS). POS represents 30.1% of cases of pyogenic spondylodiskitis. The onset of symptoms occurred an average (+/-SD) of 27.7 (+/- 25.3) days following surgery. Predisposing factors were less frequent in POS than NPOS cases (P = .002). Neurological complications and inflammatory signs in the spine were more frequent with POS than with NPOS (P = .002 and P < .00001). Coagulase-negative Staphylococcus and anaerobic bacteria were more frequent in POS than in NPOS (P = .0001 and P = .05). Percutaneous bone biopsies yielded the etiology in 66.7% of cases, open bone biopsies in 100%, blood cultures in 55.6%, and cultures of adjacent foci in 94.4%. Eleven patients (35.5%) were cured with antimicrobial treatment, but surgical treatment was necessary in 64.5%. No relapses or deaths were recorded. Seventeen patients (54.8%) had severe functional sequelae, which were associated with inflammatory signs in the spine (P = .033), higher levels of leukocytosis (P = .05), higher erythrocyte sedimentation rates (P = .05), and paravertebral abscesses (P = .04). (+info)Spondylodiscitis and epidural abscess due to Candida albicans. (3/163)
A 32-year-old woman, addicted to heroin, presented with a dorsal spondylodiscitis due to Candida albicans associated with epidural abscess. Antimycotic treatment was successful, and no neurosurgical decompression was necessary. To our knowledge, this is the first case of documented epidural involvement in candidal spondylodiscitis. The diagnosis of candidal spondylodiscitis should be considered in cases of para- or tetraplegia occurring in intravenous drug abusers. (+info)Surgical treatment of aspergillus spondylodiscitis. (4/163)
Four cases of aspergillus spondylodiscitis were treated with operative debridement and fusion. In this rarely encountered mycotic infection of the spine in immunocompromised patients rapid destruction of the intervertebral disc and vertebral bodies can occur. In advanced cases antimycotic drug therapy is thought to be ineffective and a forcing indication for surgery exists when the destruction is progressive and spinal cord compression is imminent or manifest. Spinal instrumentation can be of help in maintaining or restoring spinal stability and maintaining spinal alignment. In our four patients the aspergillus spondylodiscitis was successfully eradicated and fusion achieved. In two of three patients with a neurologic deficit, this deficit disappeared. Two patients died within 6 months after the operative treatment, due to complications related to the underlying illness. One patient was left with a subtotal paraplegia. (+info)Infective discitis as an uncommon but important cause of back pain in older people. (5/163)
CASE REPORTS: two elderly patients (aged 70 and 80 years) presented with severe back pain and restriction of spinal movements. Inflammatory markers were raised and in each case computed tomography findings confirmed infective discitis. One patient improved with antibiotics but the second developed paraplegia, a recognized complication of discitis. CONCLUSION: the association of back pain, restricted spinal movements and raised inflammatory markers should act as 'red flags', alerting the clinician to the presence of serious, but potentially treatable pathology. (+info)Candida osteomyelitis and diskitis after spinal surgery: an outbreak that implicates artificial nail use. (6/163)
Postoperative wound infection after laminectomy is uncommon. In February 1997, 3 patients were confirmed to have postlaminectomy deep wound infections due to Candida albicans. No similar case had been seen during the previous 10 years. The infections were indolent, with a mean time from initial operation to diagnosis of 54 days (range, 26-83 days). All patients were successfully treated. Pulsed-field gel electrophoresis revealed the Candida isolates to be identical. A case-controlled study and medical record review revealed that a single operating room technician scrubbed on all 3 infected case patients but on only 32% of the uninfected controls. The technician had worn artificial nails for a 3-month period that included the dates of laminectomy site infections, and C. albicans was isolated from her throat. She was treated with fluconazole and removed from duty. No subsequent cases have occurred during the ensuing 3 years. Artificial nails are known to promote subungual growth of gram-negative bacilli and yeast. This may be clinically relevant, and hospitals should enforce policies to prevent operating room personnel from wearing artificial nails. (+info)Fungal discitis due to Aspergillus terreus in a patient with acute lymphoblastic leukemia. (7/163)
We report a case of Aspergillus terreus discitis which developed in a patient with acute lymphoblastic leukemia following induction chemotherapy. A. terreus was isolated from sputum, one month earlier, but the physician did not consider it significant at the time. Magnetic resonance imaging study showed the involvement of L3-4, L4-5 and L5-S1 intervertebral discs. Etiology was established by means of histology and culturing a surgical specimen of disc materials. Our patient survived after a surgical debridement and amphotericin B administration with a total dose of 2.0 g. Discitis caused by Aspergillus terreus is a very rare event. A. terreus is one of the invasive Aspergillus species. The pathogenetic mechanism is discussed and the literature is reviewed. (+info)Discitis in young children. (8/163)
Discitis is uncommon in children and presents in different ways at different ages. It is most difficult to diagnose in the uncommunicative toddler of one to three years of age. We present 11 consecutive cases. The non-specific clinical features included refusal to walk (63%), back pain (27%), inability to flex the lower back (50%) and a loss of lumbar lordosis (40%). Laboratory tests were unhelpful and cultures of blood and disc tissue were negative. MRI reduces the diagnostic delay and may help to avoid the requirement for a biopsy. In 75% of cases it demonstrated a paravertebral inflammatory mass, which helped to determine the duration of the oral therapy given after initial intravenous antibiotics. At a mean follow-up of 21 months (10 to 40), all the spines were mobile and the patients free from pain. Radiological fusion occurred in 20% and was predictable after two years. At follow-up, MRI showed variable appearances: changes in the vertebral body usually resolved at 24 months and recovery of the disc was seen after 34 months. (+info)Discitis is a medical condition that refers to an inflammation of the intervertebral disc space, which is the area between two adjacent vertebrae in the spine. The condition is usually caused by an infection, most commonly bacterial, that spreads to the disc space from nearby tissues or the bloodstream.
The symptoms of discitis may include lower back pain, fever, and difficulty walking or standing upright. In some cases, the condition may also cause nerve root compression, leading to radiating pain, numbness, or weakness in the legs. Diagnosis of discitis typically involves imaging studies such as X-rays, MRI scans, or CT scans, as well as blood tests and sometimes a biopsy to confirm the presence of an infection.
Treatment for discitis usually involves antibiotics to treat the underlying infection, as well as pain management and physical therapy to help manage symptoms and maintain mobility. In severe cases, surgery may be necessary to remove infected tissue or stabilize the spine.
Spondylitis is a term used to describe inflammation in the spinal vertebrae, often leading to stiffness and pain. The most common form is Ankylosing Spondylitis, which is a chronic autoimmune disease where the body's immune system mistakenly attacks the joints in the spine. This can cause the bones in the spine to grow together, resulting in a rigid and inflexible spine. Other forms of spondylitis include reactive spondylitis, infectious spondylitis, and seronegative spondyloarthropathies. Symptoms may also include pain and stiffness in the neck, lower back, hips, and small joints of the body.
A percutaneous diskectomy is a minimally invasive surgical procedure to remove herniated disc material that is causing pain or neurological symptoms. "Percutaneous" means that the surgery is performed through a small incision or needle stick, rather than through a larger incision that requires muscle dissection.
During the procedure, the surgeon uses imaging guidance, such as fluoroscopy or computed tomography (CT), to guide a needle or series of needles into the affected disc space. Once the needle is in place, the surgeon uses small instruments or lasers to remove the herniated disc material that is pressing on nearby nerves or the spinal cord.
Percutaneous diskectomy is typically recommended for patients who have not responded to conservative treatments such as physical therapy, medication, and rest, and who have symptoms that are severe or worsening. The procedure is usually performed on an outpatient basis and has a shorter recovery time compared to traditional open discectomy. However, it may not be appropriate for all cases of herniated discs, particularly those with significant nerve compression or spinal instability.
An intervertebral disc is a fibrocartilaginous structure found between the vertebrae of the spinal column in humans and other animals. It functions as a shock absorber, distributes mechanical stress during weight-bearing activities, and allows for varying degrees of mobility between adjacent vertebrae.
The disc is composed of two parts: the annulus fibrosus, which forms the tough, outer layer; and the nucleus pulposus, which is a gel-like substance in the center that contains proteoglycans and water. The combination of these components provides the disc with its unique ability to distribute forces and allow for movement.
The intervertebral discs are essential for the normal functioning of the spine, providing stability, flexibility, and protection to the spinal cord and nerves. However, they can also be subject to degeneration and injury, which may result in conditions such as herniated discs or degenerative disc disease.
An epidural abscess is a localized collection of pus (abscess) in the epidural space, which is the potential space between the dura mater (the outermost membrane covering the brain and spinal cord) and the vertebral column. The infection typically occurs as a result of bacterial invasion into this space and can cause compression of the spinal cord or nerves, leading to serious neurological deficits if not promptly diagnosed and treated.
Epidural abscesses can occur in any part of the spine but are most commonly found in the lumbar region. They may develop as a complication of a nearby infection, such as a skin or soft tissue infection, or as a result of hematogenous spread (spread through the bloodstream) from a distant site of infection. Risk factors for developing an epidural abscess include diabetes, intravenous drug use, spinal surgery, and spinal instrumentation.
Symptoms of an epidural abscess may include back pain, fever, neck stiffness, weakness or numbness in the limbs, and bladder or bowel dysfunction. Diagnosis typically involves imaging studies such as MRI or CT scans, along with laboratory tests to identify the causative organism. Treatment usually consists of surgical drainage of the abscess and administration of antibiotics to eliminate the infection. In some cases, corticosteroids may be used to reduce inflammation and prevent further neurological damage.
The lumbar vertebrae are the five largest and strongest vertebrae in the human spine, located in the lower back region. They are responsible for bearing most of the body's weight and providing stability during movement. The lumbar vertebrae have a characteristic shape, with a large body in the front, which serves as the main weight-bearing structure, and a bony ring in the back, formed by the pedicles, laminae, and processes. This ring encloses and protects the spinal cord and nerves. The lumbar vertebrae are numbered L1 to L5, starting from the uppermost one. They allow for flexion, extension, lateral bending, and rotation movements of the trunk.
Radiography is a diagnostic technique that uses X-rays, gamma rays, or similar types of radiation to produce images of the internal structures of the body. It is a non-invasive procedure that can help healthcare professionals diagnose and monitor a wide range of medical conditions, including bone fractures, tumors, infections, and foreign objects lodged in the body.
During a radiography exam, a patient is positioned between an X-ray machine and a special film or digital detector. The machine emits a beam of radiation that passes through the body and strikes the film or detector, creating a shadow image of the internal structures. Denser tissues, such as bones, block more of the radiation and appear white on the image, while less dense tissues, such as muscles and organs, allow more of the radiation to pass through and appear darker.
Radiography is a valuable tool in modern medicine, but it does involve exposure to ionizing radiation, which can carry some risks. Healthcare professionals take steps to minimize these risks by using the lowest possible dose of radiation necessary to produce a diagnostic image, and by shielding sensitive areas of the body with lead aprons or other protective devices.
Geotrichosis is a fungal infection caused by the organism Geotrichum capitatum or sometimes Geotrichum candidum. This condition often affects the respiratory system, causing lung infections, but can also cause skin and mucous membrane infections. It is more commonly seen in individuals with weakened immune systems, such as those with HIV/AIDS, cancer, or organ transplants. Symptoms may include cough, shortness of breath, chest pain, fever, and weight loss. In some cases, it can lead to serious complications if left untreated.
Tuberculosis (TB) of the spine, also known as Pott's disease, is a specific form of extrapulmonary tuberculosis that involves the vertebral column. It is caused by the Mycobacterium tuberculosis bacterium, which primarily affects the lungs but can spread through the bloodstream to other parts of the body, including the spine.
In Pott's disease, the infection leads to the destruction of the spongy bone (vertebral body) and the intervertebral disc space, resulting in vertebral collapse, kyphosis (hunchback deformity), and potential neurological complications due to spinal cord compression. Common symptoms include back pain, stiffness, fever, night sweats, and weight loss. Early diagnosis and treatment with a multidrug antibiotic regimen are crucial to prevent long-term disability and further spread of the infection.
Cefazolin is a type of antibiotic known as a cephalosporin, which is used to treat a variety of bacterial infections. It works by interfering with the bacteria's ability to form a cell wall, which is necessary for its survival. Without a functional cell wall, the bacteria are not able to grow and multiply, and are eventually destroyed by the body's immune system.
Cefazolin is commonly used to treat infections of the skin, bones, joints, heart, lungs, and urinary tract. It may also be used to prevent infection during surgery. Like all antibiotics, cefazolin is only effective against certain types of bacteria, so it is important to know the specific type of bacteria causing an infection before using this medication.
Cefazolin is usually given as an injection into a vein or muscle, and may be administered in a hospital setting or at home with proper training. The dosage and duration of treatment will depend on the severity and location of the infection, as well as the patient's overall health status.
As with any medication, cefazolin can cause side effects, including diarrhea, nausea, vomiting, headache, and rash. In rare cases, it may also cause serious side effects such as allergic reactions, kidney damage, or abnormal blood clotting. It is important to report any unusual symptoms to a healthcare provider promptly.
It is essential to complete the full course of treatment with cefazolin, even if symptoms improve, to ensure that the infection is fully treated and to reduce the risk of antibiotic resistance.
Osteomyelitis is a medical condition characterized by an infection that involves the bone or the bone marrow. It can occur as a result of a variety of factors, including bacterial or fungal infections that spread to the bone from another part of the body, or direct infection of the bone through trauma or surgery.
The symptoms of osteomyelitis may include pain and tenderness in the affected area, fever, chills, fatigue, and difficulty moving the affected limb. In some cases, there may also be redness, swelling, and drainage from the infected area. The diagnosis of osteomyelitis typically involves imaging tests such as X-rays, CT scans, or MRI scans, as well as blood tests and cultures to identify the underlying cause of the infection.
Treatment for osteomyelitis usually involves a combination of antibiotics or antifungal medications to eliminate the infection, as well as pain management and possibly surgical debridement to remove infected tissue. In severe cases, hospitalization may be necessary to monitor and manage the condition.
The cervical vertebrae are the seven vertebrae that make up the upper part of the spine, also known as the neck region. They are labeled C1 to C7, with C1 being closest to the skull and C7 connecting to the thoracic vertebrae in the chest region. The cervical vertebrae have unique structures to allow for a wide range of motion in the neck while also protecting the spinal cord and providing attachment points for muscles and ligaments.
The thoracic vertebrae are the 12 vertebrae in the thoracic region of the spine, which is the portion between the cervical and lumbar regions. These vertebrae are numbered T1 to T12, with T1 being closest to the skull and T12 connecting to the lumbar region.
The main function of the thoracic vertebrae is to provide stability and support for the chest region, including protection for the vital organs within, such as the heart and lungs. Each thoracic vertebra has costal facets on its sides, which articulate with the heads of the ribs, forming the costovertebral joints. This connection between the spine and the ribcage allows for a range of movements while maintaining stability.
The thoracic vertebrae have a unique structure compared to other regions of the spine. They are characterized by having long, narrow bodies, small bony processes, and prominent spinous processes that point downwards. This particular shape and orientation of the thoracic vertebrae contribute to their role in limiting excessive spinal movement and providing overall trunk stability.
Diskectomy is a surgical procedure in which all or part of an intervertebral disc (the cushion between two vertebrae) is removed. This procedure is typically performed to alleviate pressure on nerve roots or the spinal cord caused by a herniated or degenerative disc. In a diskectomy, the surgeon accesses the damaged disc through an incision in the back or neck and removes the portion of the disc that is causing the compression. This can help to relieve pain, numbness, tingling, or weakness in the affected limb. Diskectomy may be performed as an open surgery or using minimally invasive techniques, depending on the individual case.