J Minim Invasive Spine Surg Tech.  2024 Apr;9(1):74-79. 10.21182/jmisst.2023.01053.

Delayed Fungal Infection After Anterior Lateral Interbody Fusion Treated With Oblique Lateral Interbody Fusion: A Case Report and Literature Review

• Kim SW
• Oh BK
• Son DW
• Lee JS
• Lee SH
• Kim YH
• Sung SK
• Lee SW
• Song GS

• KMID: 2562202
• DOI: http://doi.org/10.21182/jmisst.2023.01053

Abstract

This report presents a rare case of a fungal infection following an anterior lateral interbody fusion (ALIF) procedure. A 73-year-old man with rheumatoid arthritis underwent ALIF for lumbar spondylolisthesis and spinal stenosis. After surgery, he experienced severe back pain. Radiological tests showed pseudoarthrosis, osteolysis, and signs of surgical site infection. Revision surgery using oblique lateral interbody fusion (OLIF) and an allo-bone graft was performed. This addressed the complications, removed the previous cage, and provided interbody support. The patient’s pain significantly decreased, and he recovered from an Aspergillus fumigatus infection after voriconazole treatment. Follow-up examinations confirmed the infection’s resolution and the maintenance of spinal stability. It is crucial to identify fungal infections in patients on immunosuppressive drugs. The case validates the efficacy of voriconazole efficacy in treating Aspergillus spondylitis and the safety and effectiveness of OLIF for ALIF revision surgery.

Keyword

Fungal infection; Minimally invasive spine surgery; Oblique lateral interbody fusion; Revision surgery