A Rare Case of Proximal Junctional Failure with Delayed Infection after Adult Spinal Deformity Surgery: A Report of Two Cases
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 infrequ...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2020/8883828 |
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| author | Takuro Iwami Mitsuru Yagi Eijiro Okada Satoshi Suzuki Satoshi Nori Osahiko Tsuji Narihito Nagoshi Kota Watanabe Nobuyuki Fujita Masaya Nakamura Morio Matsumoto |
| author_facet | Takuro Iwami Mitsuru Yagi Eijiro Okada Satoshi Suzuki Satoshi Nori Osahiko Tsuji Narihito Nagoshi Kota Watanabe Nobuyuki Fujita Masaya Nakamura Morio Matsumoto |
| author_sort | Takuro Iwami |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-9c66daf5a9a341d9b23c11ff822187e4 |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-9c66daf5a9a341d9b23c11ff822187e42025-02-03T05:53:53ZengWileyCase Reports in Orthopedics2090-67492090-67572020-01-01202010.1155/2020/88838288883828A Rare Case of Proximal Junctional Failure with Delayed Infection after Adult Spinal Deformity Surgery: A Report of Two CasesTakuro Iwami0Mitsuru Yagi1Eijiro Okada2Satoshi Suzuki3Satoshi Nori4Osahiko Tsuji5Narihito Nagoshi6Kota Watanabe7Nobuyuki Fujita8Masaya Nakamura9Morio Matsumoto10Department of Orthopedic Surgery, Keio University School of Medicine, JapanDepartment of Orthopedic Surgery, Keio University School of Medicine, JapanDepartment of Orthopedic Surgery, Keio University School of Medicine, JapanDepartment of Orthopedic Surgery, Keio University School of Medicine, JapanDepartment of Orthopedic Surgery, Keio University School of Medicine, JapanDepartment of Orthopedic Surgery, Keio University School of Medicine, JapanDepartment of Orthopedic Surgery, Keio University School of Medicine, JapanDepartment of Orthopedic Surgery, Keio University School of Medicine, JapanDepartment of Orthopedic Surgery, Fujita Health University, JapanDepartment of Orthopedic Surgery, Keio University School of Medicine, JapanDepartment of Orthopedic Surgery, Keio University School of Medicine, JapanProximal 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.http://dx.doi.org/10.1155/2020/8883828 |
| spellingShingle | Takuro Iwami Mitsuru Yagi Eijiro Okada Satoshi Suzuki Satoshi Nori Osahiko Tsuji Narihito Nagoshi Kota Watanabe Nobuyuki Fujita Masaya Nakamura Morio Matsumoto A Rare Case of Proximal Junctional Failure with Delayed Infection after Adult Spinal Deformity Surgery: A Report of Two Cases Case Reports in Orthopedics |
| title | A Rare Case of Proximal Junctional Failure with Delayed Infection after Adult Spinal Deformity Surgery: A Report of Two Cases |
| title_full | A Rare Case of Proximal Junctional Failure with Delayed Infection after Adult Spinal Deformity Surgery: A Report of Two Cases |
| title_fullStr | A Rare Case of Proximal Junctional Failure with Delayed Infection after Adult Spinal Deformity Surgery: A Report of Two Cases |
| title_full_unstemmed | A Rare Case of Proximal Junctional Failure with Delayed Infection after Adult Spinal Deformity Surgery: A Report of Two Cases |
| title_short | A Rare Case of Proximal Junctional Failure with Delayed Infection after Adult Spinal Deformity Surgery: A Report of Two Cases |
| title_sort | rare case of proximal junctional failure with delayed infection after adult spinal deformity surgery a report of two cases |
| url | http://dx.doi.org/10.1155/2020/8883828 |
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