Adjacent intervertebral space infection after lumbar fusion

Xin, Hongkui; He, Qiang

doi:10.1007/s00132-017-3522-3

Cited by 5 publications

(10 citation statements)

References 1 publication

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“…ASI after surgery of spondylodiscitis is considered as a rare complication (1.94%) via a large cohort study [2]. ASI in uninfected spinal surgery should be rarer, and in fact, only four case reports introduced it in conventional spinal fusion surgery [3][4][5][6]. In this present case, the patient developed ASI two months after the initial instrumented lumbar fusion surgery and achieved satisfactory outcome via debridement operation and autograft bone implantation fusion after failed conservative treatment.…”

Section: Introductionmentioning

confidence: 63%

“…Nagoshi et al [6] reported three ASI cases which involved T11-12, L1-2, and L2-3. A case reported by Xin and He [5] occurred at level L3-4. Formica et al [7] and Lange et al [4] reported two ASI cases which occurred in the thoracic spine.…”

Section: Discussionmentioning

confidence: 95%

“…The adjacent segment spondylodiscitis case reported by Formica et al [7] was considered to be caused by hematogenous infection. The pedicle screw instrument which allowed the pathogen to get into the vertebral body or directly penetrated the endplate was considered as the possible reason [4,5]. The pedicle screw close to the endplate could disrupt the arterial network of the endplate, leading to the formation of septic embolus and spondylodiscitis [6].…”

Section: Discussionmentioning

confidence: 99%

“…Nagoshi et al [6] also thought the pathogenesis of ASI was just like the adjacent segment degeneration (ASD), a result of the concentrated stress at the adjacent level of spinal fusion. The disruption of the annulus fibrosus in an adjacent segment was regarded as a kind of infective route by some authors [5]. Bacteria could tend to remain at the endplate due to a disturbance in blood flow.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment strategies of ASI were similar to SSI. In patients whose infection had been diagnosed early, they can be cured through conservative antibiotic treatment [5,6]. In these publications, the most common pathogenic bacteria were Staphylococci [4,6,7].…”

Section: Discussionmentioning

confidence: 99%

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Adjacent Segment Infection after Lumbar Fusion: A Case Report and the Literature Review

Wang

Liu

2020

Case Reports in Orthopedics

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Introduction. Adjacent segment infective spondylodiscitis is a rare type of surgical spinal infection after lumbar fusion with few reports. We report a further case of adjacent segment infection after three-level lumbar fusion managed successfully with anti-infective therapy and revision surgery. Case Description. A clinical case of a 69-year-old female with multilevel lumbar degenerative disease received three-level fusion. The leading preoperative symptoms were relieved after decompression surgery. However, severe back pain recurred and prompted her to be rehospitalized 2 months later. The signal of spondylitis and discitis at the adjacent segment was detected by magnetic resonance imaging (MRI). No bacteria were identified despite blood cultures being taken before antibiotic treatment. After a long-term anti-infective therapy with vancomycin, the patient gained symptom relief and was discharged home. However, the patient complained of severe back pain again after long-term oral antibiotic treatment and was rehospitalized 6 months after surgery. The computed tomography (CT) scan showed obvious bony endplate destruction at the adjacent segment space. The patient received a debridement operation and autologous iliac bone graft. The infective inflammatory markers were controlled, and the infective space achieved fusion finally. Conclusion. Adjacent segment space infection is a rare reported complication that occurs after spinal fusion surgery. Conservative antibiotic therapy may not control the infection completely, and disc space debridement and autologous iliac bone graft can achieve ultimate fusion and a satisfactory outcome.

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Section: Introductionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Adjacent Segment Infection after Lumbar Fusion: A Case Report and the Literature Review

Wang

Liu

2020

Case Reports in Orthopedics

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A Rare Case of Proximal Junctional Failure with Delayed Infection after Adult Spinal Deformity Surgery: A Report of Two Cases

Iwami

Yagi

Okada

et al. 2020

Case Reports in Orthopedics

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Proximal junctional failure (PJF) is one of the most devastating complications that develop after adult spinal deformity (ASD) surgery. Here, we report 2 rare cases of PJF accompanied by delayed infection after ASD surgery with a review of the relevant literatures. Late-onset infection is an infrequent complication despite acute postoperative infection is common after posterior spinal instrumentation and fusion. Among them, delayed onset pyogenic spondylitis of the adjacent vertebra to the instrumented vertebrae is an extremely rare phenomenon. We do not have a clear explanation for this pathology. Since the delayed infections developed not in the fused segments but in the adjacent vertebra, the cause of the first case can be speculated as stimulation of low-virulent organisms to fester and hematogenous seeding and that of the second case as metal fretting and a sterile inflammatory response causing hematogenous microbial seeding, respectively. Additional studies on this phenomenon are warranted to elucidate the pathogenesis of this complication.

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Percutaneous transforaminal endoscopic discectomy for the treatment of lateral recess stenosis secondary occurred the discal fungus infection

Fan

Xie

Pang

et al. 2020

BMC Musculoskelet Disord

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Background: This is a case of lateral recess stenosis secondary occurred the discal fungus infection treated with percutaneous transforaminal endoscopic discectomy (PTED). There has been no relevant reports before. Case presentation: A 49-year-old patient who had taken itraconazole for 13 months for lateral recess stenosis secondary occurred the discal fungus infection complained of gradually worsening radiating pain and numbness in the back and inguinal and inner thigh region of right side. In order to relieve the radiating neuralgia and reduce the damage to spinal stability, the minimally invasive PTED was performed.The patient's prognosis was assessed using Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS). During the follow-up, the patient's ODI and VAS scores were decreased significantly. The radiating pain in the inguinal and inner thigh region of right side were significantly alleviated and the discomfort caused by lower back instability was improved by plaster vest. Discussion and conclusion: PTED not only avoids further damage to the stability of the lumbar spine, but also effectively relieves the symptoms of leg neuroradialgia caused by lateral recess stenosis secondary occurred the discal fungus infection.

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Adjacent intervertebral space infection after lumbar fusion

Abstract: Adjacent level infections can occur after spinal surgery. Early diagnosis and anti-infection treatment played an important role in the treatment of this kind of complication.

Cited by 5 publications

References 1 publication

Adjacent Segment Infection after Lumbar Fusion: A Case Report and the Literature Review

Adjacent Segment Infection after Lumbar Fusion: A Case Report and the Literature Review

A Rare Case of Proximal Junctional Failure with Delayed Infection after Adult Spinal Deformity Surgery: A Report of Two Cases

Percutaneous transforaminal endoscopic discectomy for the treatment of lateral recess stenosis secondary occurred the discal fungus infection

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