High cervical spine spondylodiscitis management and literature review

Sebben, André Luís; Graells, Xavier Soler i; Benato, Marcel Luiz; Santoro, Pedro Grein Del; Kulcheski, Álynson Larocca

doi:10.1590/1806-9282.63.01.18

Cited by 10 publications

(9 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As reported in literature, MRI is the gold standard for early confirmation and diagnosis, with a sensitivity of 93%-96% and a specificity of 92.5%-97%. 5,7 In our case, the PET investigation was not able to distinguish between an abscess or a tumor. Early blood samples are crucial as well as a DTP of 120 min between catheter and bloodstream culture time to positivity.…”

Section: Discussioncontrasting

confidence: 53%

Cervical spondylodiscitis subsequent to peripherally inserted central catheter–related sepsis: A case report

Leoni

Terranova

2018

J Vasc Access

View full text Add to dashboard Cite

Section: Discussioncontrasting

confidence: 53%

Cervical spondylodiscitis subsequent to peripherally inserted central catheter–related sepsis: A case report

Leoni

Terranova

2018

J Vasc Access

View full text Add to dashboard Cite

“…12 Although rare, cases of pyogenic spinal vertebrae infections are on the rise, which is associated to increased life expectancy and higher prevalence of comorbidities with aging that result in immunosuppression. 13,14 Misdiagnosis and delayed diagnosis can lead to devastating neurological sequelae, which is more significant when the cervical spine is involved; therefore, appropriate treatment should be initiated as soon as possible. 15 Literature supports immediate surgical debridement in traumatic cases of osteomyelitis and epidural abscesses, even in the absence of neurological symptoms.…”

Section: Discussionmentioning

confidence: 99%

Subacute Presentation of Central Cord Syndrome Resulting from Vertebral Osteomyelitis and Discitis: A Case Report

Dang

Dong

Fenati

et al. 2020

Clinical Practice and Cases in Emergency Medicine

View full text Add to dashboard Cite

Introduction: Central cord syndrome (CCS) is a clinical syndrome of motor weakness and sensory changes. While CCS is most often associated with traumatic events. There have been few documented cases being caused by abscesses resulting from osteomyelitis. Case Report: A 56-year-old male presented to a regional trauma center complaining of excruciating neck and bilateral upper extremity pain. Computed tomography of the cervical and thoracic regions revealed severe discitis and osteomyelitis of the fourth and fifth cervical (C4-C5) with near-complete destruction of the C4 vertebral body, as well as anterolisthesis of C4 on C5 causing compression of the central canal. Empiric intravenous (IV) antibiotic therapy with ampicillin/sulbactam and vancomycin was initiated, and drainage of the abscess was scheduled. After the patient refused surgery, he was planned to be transferred to a skilled nursing facility to receive a six-week course of IV vancomycin therapy. A month later, patient returned to emergency department with the same complaint due to non-compliance with antibiotic therapy. Discussion: Delayed diagnosis and treatment of osteomyelitis can result in devastating neurological sequelae, and literature supports immediate surgical debridement. Although past evidence has suggested surgical intervention in similar patients with presence of abscesses, this case may suggest that antibiotic treatment may be an alternative approach to the management of CCS due to an infectious etiology. However, the patient had been non-compliant with medication, so it is unknown whether there was definite resolution of the condition. Conclusion: In patients presenting with non-traumatic central cord syndrome, it is vital to identify risk factors for infection in a thoroughly obtained patient history, as well as to maintain a low threshold for diagnostic imaging.

show abstract

“…IS is a relatively uncommon disease, and the incidence of IS in the general population is estimated to be between 2.4 and 6.0 cases/100.000 inhabitants/year 8 . Cervical IS is the rarest form; the annual incidence varies from 0.5 to 2.5 cases per 100,000 inhabitants 9 …”

Section: Discussionmentioning

confidence: 99%

Fatal neck pain in a patient on maintenance hemodialysis

Salaouatchi

Nechita

Bossu

et al. 2020

Hemodialysis International

View full text Add to dashboard Cite

Infectious spondylodiscitis (IS) is defined as the pathogenic invasion of the vertebrae and intervertebral disks. It is a serious condition that can lead to many complications such as chronic pain, permanent neurological deficits, and even death. Vertebral surgical procedures, invasive urinary tract manipulations, and central line‐associated bloodstream infection are the primary methods by which microorganisms reach the vertebrae and intervertebral disks. Hemodialysis (HD) patients are regularly exposed to bloodstream infections due to long‐term catheter utilization or repeated vascular puncturing in patients with arteriovenous fistula. Due to the high risk of blood stream infections, HD patients have a higher risk of developing IS. Despite advanced diagnostic methods, diagnosis of spondylodiscitis is often delayed due to insidious and nonspecific symptoms, allowing dissemination of the infection, which explains the high level of mortality due to spondylodiscitis in HD patients. The infectious process typically occurs in the thoracic or lumbar region, although cervical IS does occur. We herein report the case of a 67‐year‐old man on HD who developed infectious cervical spondylodiscitis. The diagnosis was established a few days after symptom onset, but the issue was unfortunately fatal despite a well‐conducted antibiotic treatment.

show abstract

High cervical spine spondylodiscitis management and literature review

Cited by 10 publications

References 9 publications

Cervical spondylodiscitis subsequent to peripherally inserted central catheter–related sepsis: A case report

Cervical spondylodiscitis subsequent to peripherally inserted central catheter–related sepsis: A case report

Subacute Presentation of Central Cord Syndrome Resulting from Vertebral Osteomyelitis and Discitis: A Case Report

Fatal neck pain in a patient on maintenance hemodialysis

Contact Info

Product

Resources

About