K Farah1, T Graillon2, H Dufour2, S Fuentes2. 1. Department of neurosurgery, Aix-Marseille university, Timone hospital, 264, rue Saint-Pierre, 13385 Marseille, France. Electronic address: kaissar.farah@ap-hm.fr. 2. Department of neurosurgery, Aix-Marseille university, Timone hospital, 264, rue Saint-Pierre, 13385 Marseille, France.
Abstract
INTRODUCTION: Adjacent level spondylodiscitis (ALS) after primary surgery for thoracic spondylodiscitis is a very rare condition. CASE REPORT: We report the case of a 76-year-old man with this pathology. A first posterior minimally invasive approach combined with anterior approach to the thoracic spine was safely performed for thoracic spondylodiscitis. More than a year later, exploration of recurrent symptoms with 18FDG PET scan helped to diagnose ALS. Further surgery was performed. At 3-year follow-up examination showed no recurrence of the infection. DISCUSSION: ALS should be suspected during recurrent symptoms after spinal fusion surgery. Evaluation should be based on the results of 18FDG PET scan and surgery. CONCLUSION: Bacterial and histopathological analyses combined with an increase of spine fixation and adapted antimicrobial therapy are a safe management for ALS.
INTRODUCTION: Adjacent level spondylodiscitis (ALS) after primary surgery for thoracic spondylodiscitis is a very rare condition. CASE REPORT: We report the case of a 76-year-old man with this pathology. A first posterior minimally invasive approach combined with anterior approach to the thoracic spine was safely performed for thoracic spondylodiscitis. More than a year later, exploration of recurrent symptoms with 18FDG PET scan helped to diagnose ALS. Further surgery was performed. At 3-year follow-up examination showed no recurrence of the infection. DISCUSSION: ALS should be suspected during recurrent symptoms after spinal fusion surgery. Evaluation should be based on the results of 18FDG PET scan and surgery. CONCLUSION: Bacterial and histopathological analyses combined with an increase of spine fixation and adapted antimicrobial therapy are a safe management for ALS.