1/19. Primary hydatid disease of the spine: an unusual cause of progressive paraplegia. Case report and review of the literature.Although rare, spinal hydatid disease is a manifestation of hydatid infestation. The authors present the report of a patient who presented with primary spinal hydatid disease. This disease is often misdiagnosed as tuberculous spondylitis, and thus patients may subsequently receive inappropriate treatment. The patient in this case presented, with an increasing weakness in the lower limbs, to a different clinic from an area in india where hydatid infections are endemic. The infection was misdiagnosed as tuberculous spondolytis based on evaluation of plain x-ray films, and the patient underwent antituberculous chemotherapy and a posterior surgical decompressive procedure. The patient presented to the authors' clinic with increasing paraparesis 1.5 years later. Radiographs and a magnetic resonance image of the spine were obtained, which strongly suggested hydatid disease. Examination of serum levels confirmed the diagnosis. The patient underwent a decompressive procedure of the spine in which stabilization was performed. Postoperatively her paraparesis resolved, and good control over the disease was achieved by chemotherapy. The authors conclude that primary spinal hydatid disease of the spine, although a rare manifestation, should be considered in the differential diagnosis in patients with infectious and destructive lesions of the spine in regions in which the disease is endemic. Advanced imaging studies should be performed to diagnose the disease. Early decompressive surgery with stabilization of the spine, in addition to adjuvant chemotherapy, is the treatment of choice for these patients.- - - - - - - - - - ranking = 1keywords = spondylitis (Clic here for more details about this article) |
2/19. Delayed paraplegia caused by the gradual collapse of an infected vertebra.A case of delayed paraplegia caused by a gradual and progressive collapse of a vertebra after healing of pyogenic spondylitis is reported. A 73-year-old man was treated for a hematogenously seeded pyogenic spondylitis of the first lumbar vertebra. magnetic resonance imaging showed a high signal intensity of the involved vertebra and adjacent discs and a paravertebral abscess without disc space narrowing. Eight months after healing of the infection, the patient had muscle weakness and paresthesia of the lower extremities, which gradually increased. The plane radiographs revealed a kyphotic deformity of 36 degrees with a collapse of the first lumbar vertebra.- - - - - - - - - - ranking = 2keywords = spondylitis (Clic here for more details about this article) |
3/19. Chance type cervical fracture and neurological deficits in ankylosing spondylitis.Prevention of sudden neck movements is vital in patients with ankylosing spondylitis of the cervical spine. We present a case of ankylosing spondylitis who sustained a cervical fracture. He presented with paraplegia after a minor car collision and died of pulmonary embolism after the operation for anterior stabilisation. We believe that the most important matter in a patient with advanced ankylosing spondylitis is the prevention of the fractures and complications. The need for neck protection in automobiles was emphasized and the literature reviewed about the occurrences of neurological deficits following trauma.- - - - - - - - - - ranking = 7keywords = spondylitis (Clic here for more details about this article) |
4/19. Multilevel epidural abscess formation with paraplegia in a healthy 33-year-old man caused by staphylococcus aureus (MSSA).We report an unusual case of a devastating multilevel pyogenic spondylitis with paraplegia and soft tissue abscess formation in a previously healthy young man. methicillin susceptible staphylococcus aureus (MSSA) was identified as causal pathogen. The infection could only be managed after surgical debridement of all spinal manifestations and a prolonged course of antibiotic therapy. It is possible that delayed surgical debridement of all infection sites fostered the course of the disease.- - - - - - - - - - ranking = 1keywords = spondylitis (Clic here for more details about this article) |
5/19. Brucellar spondylitis: a rare cause of spinal cord compression.STUDY DESIGN: A case report. OBJECTIVES: To present and discuss some of the difficulties in the diagnosis of brucellar spondylitis. SETTING: Ankara University, Ibni Sina Hospital, turkey. methods: We report a patient with paraplegia, misdiagnosed as having a malignancy or tuberculosis who actually suffered from brucellar spondylitis. Diagnosis was established by her history and a compatible clinical picture together with a standard tube agglutination (Wright test) titer of > or =1/160 of antibodies for brucellosis. The patient was treated with oral doxycycline, rifampicin, and ciprofloxacin combination. RESULTS: At the end of the treatment, the blood brucella Wright and anti-human globulin T titer levels decreased. Her lower limb weakness improved. She could walk, and climb stairs with the help of a cane. urinary retention and fecal incontinence also resolved. CONCLUSION: brucellosis is a systemic infection involving the musculoskeletal and nervous systems. spondylitis frequently occurs in elderly patients. An early diagnosis of brucellar spondylitis can often be difficult. In endemic regions, as in the case of our country, brucellar spondylitis should always be considered in the differential diagnosis of older patients with back pain and constitutional symptoms. An early diagnosis will help to prevent the development of more severe complications such as spinal cord compression.- - - - - - - - - - ranking = 8keywords = spondylitis (Clic here for more details about this article) |
6/19. Case report 709: Transverse fracture with epidural and small paravertebral hematomata, in a patient with ankylosing spondylitis.This case demonstrates the potential pitfall of obtaining CT images in the axial plane alone, with a fracture parallel to the imaging plane mimicking vertebral body destruction and associated epidural mass mimicking neoplasm. Chan et al. have discussed the value of reformatted CT images in coronal and sagittal planes to define better transverse vertebral fractures. The case also demonstrates the potential danger of bypassing plain radiographs with the aim of facilitating a rapid diagnosis. Plain films, performed in this case only after CT myelography, clearly demonstrated a transverse pathological fracture in an ankylosed spine with no evidence of neoplastic destruction, enabling easy diagnosis of SEH on the CT appearance. The delayed onset of neurological deficit after fracture reinforces the importance of education of the patient with AS. This principally involves altering patients to the fragility of their spine and to the importance of avoiding spinal trauma. However, patients with known AS should be warned to seek medical advice after even minor spinal trauma with the aim of minimizing the incidence of delayed neurological complications such as occurred in this patient.- - - - - - - - - - ranking = 4keywords = spondylitis (Clic here for more details about this article) |
7/19. Thoracic aortic pseudoaneurysm after spine trauma in ankylosing spondylitis. Case report.Ankylosing spondylitis (AS) is a rheumatic disease characterized by consolidation of the articulating surfaces and inflammation of the vertebral column. Because of its associated spine stiffness and secondary osteoporosis, patients with this disorder are at increased risk of vertebral fractures. Ankylosing spondylitis presents a significant challenge to spine surgeons because of its complex effects on the spine, extraarticular organ manifestations, and potential neurological and functional sequelae. Traumatic thoracic and lumbar spine injuries in this patient population may be associated with injury to the aorta either due to direct mechanical trauma or to blunt forces associated with the spine fracture. This complication and association is thought to be the result of pathophysiological changes that cause the aorta to become firmly adherent to the anterior longitudinal ligament. The authors present a case of AS in a patient with a thoracic spine fracture and in whom a delayed thoracic aortic pseudoaneurysm ruptured. To the best of the authors' knowledge, only five cases of this complex condition have been reported since 1980. Recognition of the potential for aortic injury in patients with AS should prompt early investigation of the aorta in cases involving numerous fractures and assist in surgical planning to avoid this lethal injury.- - - - - - - - - - ranking = 6keywords = spondylitis (Clic here for more details about this article) |
8/19. paraplegia caused by spinal infection after acupuncture.STUDY DESIGN: Case report of a 64-year-old man with psoas abscesses, epidural abscess and spondylitis after acupuncture. OBJECTIVE: To report a case of paraplegia caused by spinal infection after acupuncture. SETTING: Seoul, korea. CASE REPORT: A 64-year-old man came to an emergency room because of severe back pain. At 3 days prior to visit, the patient received acupuncture therapy to the low back with a needle about 10 cm in length because of back pain. Pain was aggravated gradually for 3 days. escherichia coli sepsis developed with altered mentality during admission. At hospital day 9, he regained his consciousness and was found to have paraplegia. Abdominal computerized tomography (CT) and lumbar spine magnetic resonance imaging (MRI) revealed abscesses of bilateral psoas muscles and spondylitis with epidural abscess. After conservative management with intravenous administration of antibiotics, infection was controlled but the patient remained paraplegic (asia scale C L1 level) without neurological recovery. CONCLUSION: paraplegia might result from complications of an acupuncture therapy.- - - - - - - - - - ranking = 2keywords = spondylitis (Clic here for more details about this article) |
9/19. Pyogenic spondylitis in the cervicothoracic junction with high-positioned aortic arch. Case report and review of the literature.The authors report the case of an 87-year-old woman who suffered from T1-2 pyogenic spondylitis resulting in progressive and severe paraplegia. debridement and anterior manubrium-splitting fusion were difficult because a high-positioned aortic arch was very close to the infectious lesion. Because adequate intravenous antibiotic agents had nearly resolved the inflammation, the authors undertook anterior debridement and posterior fusion that involved costotransversectomy and the placement of a posterior cervical pedicle screw fixation system. At 1.5 years postoperatively, there were no signs of recurrent infection. Solid osseous union was documented, and the patient's paraplegia had improved. A high-positioned aortic arch will likely interfere with an anterior approach to the cervicothoracic junction. If adequate antibiotic therapy has successfully controlled the spinal infection, anterior debridement and posterior fusion can be conducted in cases involving such anatomical limitations.- - - - - - - - - - ranking = 5keywords = spondylitis (Clic here for more details about this article) |
10/19. Pott disease in the thoracolumbar spine with marked kyphosis and progressive paraplegia necessitating posterior vertebral column resection and anterior reconstruction with a cage.STUDY DESIGN: Case report. OBJECTIVES: To report on a patient with Pott disease, progressive neurologic deficit, and severe kyphotic deformity, who had medical treatment fail and required posterior/anterior decompression with instrumented fusion. Treatment options will be discussed. SUMMARY OF BACKGROUND DATA: Tuberculous spondylitis is an increasingly common disease worldwide, with an estimated prevalence of 800,000 cases. methods: Surgical treatment consisting of extensive posterior decompression/instrumented fusion and 3-level posterior vertebral column resection, followed by anterior debridement/fusion with cage reconstruction. RESULTS: Neurologic improvement at 6-month follow-up (Frankel B to Frankel D), with evidence of radiographic fusion. CONCLUSIONS: A 70-year-old patient with progressive Pott paraplegia and severe kyphotic deformity, for whom medical treatment failed is presented. A posterior vertebral column resection, multiple level posterior decompression, and instrumented fusion, followed by an anterior interbody fusion with cage was used to decompress the spinal cord, restore sagittal alignment, and debride the infection. At 6-month follow-up, the patient obtained excellent pain relief, correction of deformity, elimination of the tuberculous foci, and significant recovery of neurologic function.- - - - - - - - - - ranking = 1keywords = spondylitis (Clic here for more details about this article) |
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