Abstract
Introduction
Acute pyogenic spondylodiscitis caused by percutaneous vertebroplasty is a rare complication. We present the first report of minimally invasive endoscopic treatment for acute spondylodiscitis caused by vertebroplasty.
Case presentation
A 60-year-old female was transferred with the symptom of right hip flexion weakness for 1 day. The patient underwent a vertebroplasty procedure because of L3 osteoporotic compression fracture at other hospital 6 weeks ago. Physical examination, laboratory finding and magnetic resonance imaging revealed an acute pyogenic spondylodiscitis with right L2 nerve root palsy caused by compression of bone and cement after L3 body collapse. Percutaneous endoscopic procedures including needle biopsy, debridement, root decompression and drainage were performed. One week after endoscopic treatment, her symptoms of back pain and nerve palsy improved significantly. After endoscopic treatment, the patient underwent conservative treatment with appropriate antibiotics according to the bacterial culture test results. Six weeks postoperatively, she was pain free with no neurological deficits or signs of infection. Five months later, spontaneous fusion between L2 and L3 body was observed.
Conclusion
We report a case treated with endoscopic procedure without open surgery for acute pyogenic spondylodiscitis following vertebroplasty.
Similar content being viewed by others
References
Abdelrahman H, Siam AE, Shawky A, Ezzati A, Boehm H (2013) Infection after vertebroplasty or kyphoplasty. A series of nine cases and review of literature. Spine J 13:1809–1817
Fu TS, Chen LH, Chen WJ (2013) Minimally invasive percutaneous endoscopic discectomy and drainage for infectious spondylodiscitis. Biomed J 36:168–174
Anselmetti GC, Marcia S, Saba L, Muto M, Bonaldi G, Carpeggiani P, Marini S, Manca A, Masala S (2012) Percutaneous vertebroplasty: multi-centric results from EVEREST experience in large cohort of patients. Eur J Radiol 81:4083–4086
Shin JH, Ha KY, Kim KW, Lee JS, Joo MW (2008) Surgical treatment for delayed pyogenic spondylitis after percutaneous vertebroplasty and kyphoplasty. Report of 4 cases. J Neurosurg Spine 9:265–272
Yu SW, Chen WJ, Lin WC, Chen YJ, Tu YK (2004) Serious pyogenic spondylitis following vertebroplasty—a case report. Spine 29:E209–E211
Alfonso Olmos M, Silva Gonzalez A, Duart Clemente J, Villas Tome C (2006) Infected vertebroplasty due to uncommon bacteria solved surgically: a rare and threatening life complication of a common procedure: report of a case and a review of the literature. Spine 31:E770–E773
Gaye M, Fuentes S, Pech-Gourg G, Benhima Y, Dufour H (2008) Spondylitis following vertebroplasty. Case report and review of the literature. Neurochirurgie 54:551–555
Lee MJ, Dumonski M, Cahill P, Stanley T, Park D, Singh K (2009) Percutaneous treatment of vertebral compression fractures: a meta-analysis of complications. Spine 34:1228–1232
Lin WC, Lee CH, Chen SH, Lui CC (2008) Unusual presentation of infected vertebroplasty with delayed cement dislodgment in an immunocompromised patient: case report and review of literature. Cardiovasc Intervent Radiol 31:S231–S235
Walker DH, Mummaneni P, Rodts GE Jr (2004) Infected vertebroplasty. Report of two cases and review of the literature. Neurosurg Focus 17:E6
Ito M, Abumi K, Kotani Y, Kadoya K, Minami A (2007) Clinical outcome of posterolateral endoscopic surgery for pyogenic spondylodiscitis: results of 15 patients with serious comorbid conditions. Spine 32:200–206
Yang SC, Fu TS, Chen LH, Niu CC, Lai PL, Chen WJ (2007) Percutaneous endoscopic discectomy and drainage for infectious spondylitis. Int Orthop 31:367–373
Yang SC, Chen WJ, Chen HS, Kao YH, Yu SW, Tu YK (2014) Extended indications of percutaneous endoscopic lavage and drainage for the treatment of lumbar infectious spondylitis. Eur Spine J 23:846–853
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None of the authors has any potential conflict of interest.
Rights and permissions
About this article
Cite this article
Youn, M.S., Shin, J.K., Goh, T.S. et al. Minimally invasive percutaneous endoscopic treatment for acute pyogenic spondylodiscitis following vertebroplasty. Eur Spine J 27 (Suppl 3), 458–464 (2018). https://doi.org/10.1007/s00586-018-5478-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-018-5478-3