J Korean Soc Spine Surg.  2009 Mar;16(1):59-63. 10.4184/jkss.2009.16.1.59.

Surgical Treatment of Brucellar Spondylodiscitis with Epidural Abscess: A Case Report

Affiliations
  • 1Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea. chungkjmd@dreamwiz.com
  • 2Department of Radiology, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Korea.
  • 3Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Korea.

Abstract

Brucellosis is a well known systemic, zoonotic disease that can affect many organs. We report a rare case of spondylodiscitis with an epidural abscess caused by brucellosis. The patient was treated surgically for severe pain and concomitant devastating neurological deficit. A diagnosis of spondylodiscitis or an epidural abscess due to brucellosis must be considered when acute back pain, radiating pain and febrile episodes occur, particularly in people in a high risk group.

Keyword

Brucellosis; Spondylodiscitis; Epidural abscess; Surgical treatment

MeSH Terms

Back Pain
Brucellosis
Discitis
Epidural Abscess
Humans

Figure

  • Fig. 1. Lateral view of lumbar spi ne showed localized bony erosion was found at anterosuperior corner of L3.

  • Fig. 2. Sagittal MRI showed low signal intensity on T1-weighted image and hyperintensity on T2-weighted image and homogeneous contrast enhancement of L3 verterba body and multiseptated epidural abscess.

  • Fig. 3. Axial MR image showed epidral abscess and paravertebral abscess with peripheral enhancement. Cauda equina was compressed within canal and foramen by inflammatory granulation tissue.

  • Fig. 4. Posteior instrumentation and anterior lumbar interbody fusion with autogenous iliac bone graft was performed and 1 year after operation solid union was found.


Reference

01). Serre H., Blotman F., Sany J., Simon L. Infectious spondy-lodiskitis: Symptoms and course. Rev Rheum Mal Osteoartic. 1973. 40:243–253.
02). Shim DM., Park JY. Clinical findings of brucellar spondylitis. a case report. J Korean Orthop Assoc. 2007. 42:136–140.
03). Kaye D. Brucellosis. Wilson JD, Braunwald E, Issel-bacher KJ, Petersdorf RG, Martin JB, editors. Harrison's Principles of Internal Medicine, Ed 12. New York: McGraw-Hill;1991. p. 625–626.
04). Aydin G., Tosun A., Keles I., Ayaslioglu E., Tosun O., Orkun S. Brucellar spondylodiscitis: a case report. Int J Clin Pract. 2006. 60:1502–1505.
Article
05). Harman M., Unal O., Onbasi KT., Kiymaz N., Arslan H. Brucellar spondylodiscitis: MRI diagnosis. Clin Imaging. 2001. 25:421–427.
06). Sharif HS., Aideyan OA., Clark DC, et al. Brucellar and tuberculous spondylitis: comparative imaging features. Radiology. 1989. 171:419–425.
Article
07). Ozaksoy D., Yucesoy K., Yucesoy M., Kovanlikaya I., Yuce A., Naderi S. Brucellar spondylitis mpact fracture of the lumbar vertebrae with dural tear. J Neurosurgery. 1980. 53:765–771.
08). Turgut M., Turgut A., Kosar U. Spinal brucellosis: Turkish experience based on 452 case published during the last century. Act Neurochir (Wien). 2006. 148:1033–1044.
09). Bayindir Y., Sonmerz E., Aladag A., Buyukberber N. Comparison of five antimicrobial regimens for the treatment if brucellar spondylitis: a prospectiv, randomized study. J Chemother. 2003. 15:466–471.
10). Skalsky K., Yahav D., Bishara J., Pitlik S., Leibovici L., Paul M. Treatment of human brucelosis: systematic review and meta-analysis of randomized controlled trials. British Medical Joiurnal. 2008. 336:701–704.
11). Katonis P., Tzermiadianos M., Gikas A., Papagelopoulos P., Hadjipavlou A. Surgical treatment of spinal brucellosis. Clin Orthop Relat Res. 2006. 444:66–72.
Article
Full Text Links
  • JKSS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr