Korean J Pain.  2013 Apr;26(2):181-185. 10.3344/kjp.2013.26.2.181.

Spondylodiscitis after Cervical Nucleoplasty without Any Abnormal Laboratory Findings

• Lee SJ
• Choi EJ
• Nahm FS

• KMID: 1978666
• DOI: http://doi.org/10.3344/kjp.2013.26.2.181

Abstract

Infective spondylodiscitis is a rare complication that can occur after interventional spinal procedures, of which symptoms are usually back pain and fever. Early diagnosis of infective spondylodiscitis is critical to start antibiotics and to improve prognosis. Laboratory examinations including complet blood cell count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) are conventional tools for the early detection of infectious spondylitis. However, we experienced infective spondylodiscitis after cervical nucleoplasty which did not display any laboratory abnormalities, but was diagnosed through an MRI. A patient with cervical disc herniation received nucleoplasty at C5/6 and C6/7. One month later, the patient complained of aggravated pain. There were neither signs of chill nor fever, and the laboratory results appeared normal. However, the MRI findings were compatible with infectious spondylodiscitis at the nucleoplasty site. In conclusion, infectious spondylodiscitis can develop after cervical nucleoplasty without any laboratory abnormalities. Therefore, an MRI should be taken when there is a clinical suspicion for infection in order to not miss complications after interventional procedures, even if the laboratory findings are normal.

Keyword

complication; infection; magnetic resonance imaging; nucleoplasty; spondylodiscitis

MeSH Terms

Anti-Bacterial Agents
Back Pain
Blood Cell Count
Blood Sedimentation
C-Reactive Protein
Discitis
Early Diagnosis
Fever
Humans
Magnetic Resonance Imaging
Prognosis
Spondylitis
Anti-Bacterial Agents
C-Reactive Protein

Figure

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  Fig. 1 Nucleoplasty at the C5/6 disc. (A) Anterior-posterior view and (B) lateral view.

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  Fig. 2 MR image after 6 weeks. C6/7 spondylodischitis is identified. (A) T2 sagittal view and (B) T2 axial view.

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