Adjacent Segment Infection after Lumbar Fusion: A Case Report and the Literature Review
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. Ca...
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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/10.1155/2020/2163909 |
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| author | Wenlong Wang Zheng Liu Sijun Wu |
| author_facet | Wenlong Wang Zheng Liu Sijun Wu |
| author_sort | Wenlong Wang |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-d1d5c3657d3b4ee78897fd54ff649634 |
| 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-d1d5c3657d3b4ee78897fd54ff6496342025-02-03T00:59:42ZengWileyCase Reports in Orthopedics2090-67492090-67572020-01-01202010.1155/2020/21639092163909Adjacent Segment Infection after Lumbar Fusion: A Case Report and the Literature ReviewWenlong Wang0Zheng Liu1Sijun Wu2Department of Orthopedics, Peking University Shougang Hospital, Shijingshang District, Beijing 100144, ChinaDepartment of Orthopedics, Peking University Shougang Hospital, Shijingshang District, Beijing 100144, ChinaDepartment of Orthopedics, Peking University Shougang Hospital, Shijingshang District, Beijing 100144, ChinaIntroduction. 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.http://dx.doi.org/10.1155/2020/2163909 |
| spellingShingle | Wenlong Wang Zheng Liu Sijun Wu Adjacent Segment Infection after Lumbar Fusion: A Case Report and the Literature Review Case Reports in Orthopedics |
| title | Adjacent Segment Infection after Lumbar Fusion: A Case Report and the Literature Review |
| title_full | Adjacent Segment Infection after Lumbar Fusion: A Case Report and the Literature Review |
| title_fullStr | Adjacent Segment Infection after Lumbar Fusion: A Case Report and the Literature Review |
| title_full_unstemmed | Adjacent Segment Infection after Lumbar Fusion: A Case Report and the Literature Review |
| title_short | Adjacent Segment Infection after Lumbar Fusion: A Case Report and the Literature Review |
| title_sort | adjacent segment infection after lumbar fusion a case report and the literature review |
| url | http://dx.doi.org/10.1155/2020/2163909 |
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