Fungal vertebral osteomyelitis by mucormycosis is extremely rare. We report a 16-year-old patient with newly diagnosed acute lymphoid leukaemia who developed extensive vertebral osteomyelitis caused by mucormycosis. He was treated with three-level subtotal spondylectomy and long-term oral antifungal medications. He had no neurological deficit after the operation.
Introduction: Symptomatic thoracic stenosis is an uncommon disease in contrast to cervical and lumbar stenosis. It has been reported that ossification of ligamentum flavum (OLF) is the most common cause of thoracic myelopathy in our locality. Materials and methods: All patients with symptomatic thoracic spinal stenosis secondary to OLF who underwent operative treatment in our institution between January 1999 and December 2013 were retrospectively reviewed for demographic data, causes, complications and surgical outcomes. Results: Twenty-six patients who underwent surgical treatment for symptomatic OLF were followed up for an average period of 71.3 months. All patients received decompression with concomitant instrumented fusion in 2 patients (7.7%). In our series, we had 2 cases (7.7%) of early post-operative neurological deterioration secondary to haematoma formation. Four cases (15.4%) were complicated with cerebrospinal fluid leakage. Operative outcome was reported in Frankel classification and modified Japanese Orthopedic Association (JOA) scale for thoracic myelopathy. After operation, 8 patients (30.8%) showed improvement in their Frankel grade, while 16 patients (61.5%) had no change and 2 patients (7.7%) reported deterioration. Mean JOA score showed significant improvement from 5.1 (range 2e8) to 6.9 post-operatively (range 2e11). Discussion and conclusion: OLF is the most common cause of thoracic myelopathy in our locality. Early accurate diagnosis and adequate surgical decompression are important for favourable outcomes despite operative difficulties and possible complications.
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