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https://www.readbyqxmd.com/read/29656303/spondylodiscitis-following-endovascular-abdominal-aortic-aneurysm-repair-imaging-perspectives-from-a-single-centre-s-experience
#1
Ramin Mandegaran, Christopher S W Tang, Erlick A C Pereira, Ali Zavareh
OBJECTIVE: Very few reports have previously described spondylodiscitis as a potential complication of endovascular aortic aneurysm repair (EVAR). We present to our knowledge the first case series of spondylodiscitis following EVAR based on our institution's experience over an 11-year period. Particular attention is paid to the key imaging features and challenges encountered when performing spinal imaging in this complex patient group. MATERIALS AND METHODS: Of 1,847 patients who underwent EVAR at our institution between January 2006 and January 2017, a total of 9 patients were identified with imaging features of spondylodiscitis (0...
April 14, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29649612/independent-predictors-of-spinal-epidural-abscess-recurrence
#2
Akash A Shah, Huiliang Yang, Paul T Ogink, Joseph H Schwab
BACKGROUND CONTEXT: Recurrence of spinal epidural abscess (SEA) after treatment is an important cause of continued morbidity for patients. PURPOSE: The purpose of this study is to identify independent predictors of recurrence of SEA. STUDY DESIGN/SETTING: This was a retrospective, case-control study. PATIENT SAMPLE: Patients 18 years or older with a diagnosis of SEA admitted to our hospital system during the study period were included in the study sample...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29649397/management-of-a-cancer-patient-with-an-intrathecal-drug-delivery-system-and-an-acute-brain-abscess
#3
David R Walega, Marc Korn
Surgical-site infection, spinal cord abscess, and catheter tip granuloma are known but rare complications of intrathecal drug delivery systems (IDDS). To date, there are no published cases of brain abscess in a patient with an IDDS. In this study, we report a case of a cancer patient with an IDDS for management of cancer pain who developed a brain abscess with profound mental status changes and clinical management challenges.
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29626020/bone-and-joint-infection
#4
Julia Colston, Bridget Atkins
Bone and joint infections include septic arthritis, prosthetic joint infections, osteomyelitis, spinal infections (discitis, vertebral osteomyelitis and epidural abscess) and diabetic foot osteomyelitis. All of these may present through the acute medical take. This article discusses the pathogenesis of infection and highlights the importance of taking a careful history and fully examining the patient. It also emphasises the importance of early surgical intervention in many cases. Consideration of alternative diagnoses, appropriate imaging and high-quality microbiological sampling is important to allow appropriate and targeted antimicrobial therapy...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29613923/nonoperative-management-of-spinal-epidural-abscess-development-of-a-predictive-algorithm-for-failure
#5
Akash A Shah, Paul T Ogink, Sandra B Nelson, Mitchel B Harris, Joseph H Schwab
BACKGROUND: Prompt diagnosis and treatment are critical in spinal epidural abscess, as delay can lead to paralysis or death. The initial management decision for spinal epidural abscess is not always clear, with the literature showing conflicting results. When considering nonoperative management, it is crucial to avoid failure of treatment, given the neurologic compromise incurred through failure. Unfortunately, data regarding risk factors associated with failure are scarce. METHODS: All patients admitted to our hospital system with a diagnosis of spinal epidural abscess from 1993 to 2016 were identified...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29600211/unusual-presentation-of-spinal-gout-2-cases-report-and-literature-review
#6
Wesley Ng, Cheuk Hang Sin, Chong Hing Wong, Wing Fat Chiu, On Ming Chung
Introduction: Gouty spondyloarthropathy is generally believed to be uncommon. Together with the fact that it can mimic a variety of disease entities, it imposes significant diagnostic challenge in our clinical practice. In this article, we report two patients diagnosed with spinal gout, and both were initially suspected to have a pyogenic infection. Case Reports: The first patient, a 66-year-old man, was admitted for fever and a short history of bilateral upper limb weakness...
November 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29595747/postoperative-infection-in-patients-undergoing-posterior-lumbosacral-spinal-surgery-a-pictorial-guide-for-diagnosis-and-early-treatment
#7
Shih-Hao Chen, Wen-Jer Chen, Meng-Huang Wu, Jen-Chung Liao, Chen-Ju Fu
Surgical site infections after posterior spinal surgery may lead to spondylodiscitis, pseudarthrosis, correction loss, adverse neurological sequelae, sepsis, and poor outcomes if not treated immediately. Infection rates vary depending on the type and extent of operative procedures, use of instrumentation, and patients' risk factors. Image evaluation is crucial for early diagnosis and should be complementary to clinical routes, laboratory survey, and treatment timing. Magnetic resonance imaging detects early inflammatory infiltration into the vertebrae and soft tissues, including hyperemic changes of edematous marrow, vertebral endplate, and abscess or phlegmon accumulation around the intervertebral disk, epidural, and paravertebral spaces...
March 27, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29588297/intrathecal-spinal-abscesses-due-to-candida-albicans-in-an-immunocompetent-man
#8
John K Crane
Infections of the central nervous system due to Candida albicans are uncommon and are usually only observed in special circumstances, such as following neurosurgery or penetrating head trauma, in immunosuppressed patients, premature infants or in patients with ventriculoperitoneal shunts. The author reports a case of an immunocompetent man who presented with a thoracic intraspinal abscess due to C. albicans Despite surgical drainage and 6 weeks of high-dose fluconazole therapy, the abscess extended and recurred in the cervical spine, requiring a second operation to arrest the infection...
March 27, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29584512/acute-prevertebral-abscess-secondary-to-intradiscal-oxygen-ozone-chemonucleolysis-for-treatment-of-a-cervical-disc-herniation
#9
Chun-Sheng Yang, Lin-Jie Zhang, Zhi-Hua Sun, Li Yang, Fu-Dong Shi
Objective We herein present a case involving a prevertebral abscess complicated by a spinal epidural abscess (SEA) secondary to intradiscal oxygen-ozone chemonucleolysis for treatment of a cervical disc herniation. Methods A 67-year-old woman with a history of intradiscal oxygen-ozone chemonucleolysis developed numbness and weakness in her right upper and bilateral lower extremities followed by urinary retention. Her symptoms did not respond to intravenous antibiotics alone. Magnetic resonance imaging of the cervical region revealed an extensive SEA anterior to the spinal cord, spinal cord myelopathy due to anterior compression by the lesion, and a prevertebral abscess extending from C2 to T1...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29582111/clinical-utility-of-diffusion-weighted-imaging-in-spinal-infections
#10
Rebecca A Dumont, Nayela N Keen, Courtnay W Bloomer, Brian S Schwartz, Jason Talbott, Aaron J Clark, David M Wilson, Cynthia T Chin
PURPOSE: Both laboratory markers and radiographic findings in the setting of spinal infections can be nonspecific in determining the presence or absence of active infection, and can lag behind both clinical symptoms and antibiotic response. Magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) has been shown to be helpful in evaluating brain abscesses but has not been commonly used in evaluating spinal infections. We aimed to correlate findings on DWI of the spine to results of microbiological sampling in patients with suspected spinal infections...
March 26, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29576110/haematoma-and-abscess-after-neuraxial-anaesthesia-a-review-of-647-cases
#11
REVIEW
E M E Bos, J Haumann, M de Quelerij, W P Vandertop, C J Kalkman, M W Hollmann, P Lirk
Although rare, spinal haematoma and abscess after central neuraxial blocks may cause severe permanent neurological injury. Optimal treatment and outcome remain unclear. In order to identify possible predisposing patient characteristics and describe the ensuing clinical course, we searched Medline, Embase, and the Cochrane Library for reports of spinal haematomas and abscesses associated with central neuraxial blocks. Extracted data included patient characteristics, symptoms, treatment, and outcome. We analysed 409 reports, including 647 patients (387 patients with spinal haematoma and 260 patients with spinal abscess)...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29567652/transforaminal-lumbar-puncture-an-alternative-technique-in-patients-with-challenging-access
#12
D R Nascene, C Ozutemiz, H Estby, A M McKinney, J B Rykken
Interlaminar lumbar puncture and cervical puncture may not be ideal in all circumstances. Recently, we have used a transforaminal approach in selected situations. Between May 2016 and December 2017, twenty-six transforaminal lumbar punctures were performed in 9 patients (25 CT-guided, 1 fluoroscopy-guided). Seven had spinal muscular atrophy and were referred for intrathecal nusinersen administration. In 2, CT myelography was performed via transforaminal lumbar puncture. The lumbar posterior elements were completely fused in 8, and there was an overlying abscess in 1...
March 22, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29560054/a-predictive-model-facilitates-early-recognition-of-spinal-epidural-abscess-in-adults
#13
Andrew W Artenstein, Jennifer Friderici, Paul Visintainer
Introduction: Spinal epidural abscess (SEA), a highly morbid and potentially lethal deep tissue infection of the central nervous system has more than tripled in incidence over the past decade. Early recognition at the point of initial clinical presentation may prevent irreversible neurologic injury or other serious, adverse outcomes. To facilitate early recognition of SEA, we developed a predictive scoring model. Methods: Using data from a 10-year, retrospective, case-control study of adults presenting for care at a tertiary-care, regional, academic medical center, we used the Integrated Discrimination Improvement Index (IDI) to identify candidate discriminators and created a multivariable logistic regression model, refined based on p-value significance...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29545868/diagnosis-and-management-of-spinal-tuberculosis-combined-with-brucellosis-a-case-report-and-literature-review
#14
Dexin Zou, Junlin Zhou, Xiaobing Jiang
Tuberculosis combined with brucellosis is a very rare condition. Overlapping clinical presentation and laboratory parameters of tuberculosis and brucellosis may lead to misdiagnosis or delayed diagnosis of the condition. The current study presents the case of a 45-year-old male with symptoms of lower back pain, non-tender swelling in the right flank, intermittent hyperpyrexia, sweating, body aches and numbness and weakness of right lower limb. A lumbar computed tomograph (CT) scan and magnetic resonance imaging indicated vertebral destruction and the formation of sequestra and thecal sac compression...
April 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29531797/aspergillus-spinal-epidural-abscess-case-presentation-and-review-of-the-literature
#15
Faris Shweikeh, Stephanie Zyck, Fadi Sweiss, Ajleeta Sangtani, Mohammed Shweikeh, Husam Issa, Michael P Steinmetz, Georges Z Markarian
Study design: In this review, we present a case of Aspergillus spinal epidural abscess (ASEA) and review the literature. Objectives: To provide further insight on a rare condition. Setting: A description of a patient with ASEA in a 58-year-old woman that was successfully treated with conservative management is presented. Methods: Following case presentation, a literature search (MedLine and PubMed) and assessment of epidemiology, presentation, diagnosis, treatments, and outcomes is performed...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/29526779/tuberculous-spondylolisthesis-a-re-appraisal-on-clinico-radiologic-spectrum-and-surgical-treatment-paradigm
#16
REVIEW
Vinayak Narayan, Nasser Mohammed, Amey R Savardekar, Devi Prasad Patra, Anil Nanda
INTRODUCTION: Spinal tuberculosis [TB] is a common infectious disease prevalent in developing countries and a rising disaster in developed countries. The association of tuberculosis with spondylolisthesis is rarely reported in literature. The aim of our review is to analyse the clinical features and radiologic characteristics of TB spondylolisthesis along with providing a concise update on its surgical management, based on current literature. METHODS: A systematic review is performed after conducting a thorough search in the PubMed database...
March 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29521260/tuberculous-lumbar-spinal-epidural-abscess-in-a-young-adult-case-report
#17
Ghazwan Abdulla Hasan, Saif Mohammed Kani, Ahmed Alqatub
INTRODUCTION: Spinal Epidural abscess (SEA) is an uncommon pathology that needs an urgent intervention to decompress the pressure on the spinal epidural sac, cord, and roots. The authors report a rare case of a young adult with lumbar spinal epidural tuberculous abscess occupying the spinal canal from L2-L5 vertebrae with extesion to the posterior paraspinal muscles and presenting with bilateral progressive lower limb weakness.   Case report: A 42 years old male teacher presented with a 15-day history of progressive difficulty to walking and bilateral lower limb weakness associated with fever, malaise and later on urinary incontinence...
2018: SICOT-J
https://www.readbyqxmd.com/read/29516616/epidural-abscess-during-a-spinal-cord-stimulator-trial-a-case-report
#18
Brian Wetherington, Talal W Khan
BACKGROUND: Spinal cord stimulation (SCS) can be beneficial for low back and radicular pain. A short trial of SCS evaluates the potential effectiveness of this therapy for a specific patient, while also decreasing the likelihood of a failed permanent implant. While rare, an epidural abscess is difficult to diagnose based on its nonspecific and unreliable clinical presentation. CASE: We present a case of an acute onset methicillin-sensitive Staphylococcus aureus epidural abscess 72-96 hours into a trial of a percutaneous spinal cord stimulator...
March 8, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29505022/skipped-multifocal-extensive-spinal-tuberculosis-involving-the-whole-spine-a-case-report-and-literature-review
#19
Minhao Wu, Jiajia Su, Feifei Yan, Lin Cai, Zhouming Deng
RATIONALE: Skipped multifocal extensive spinal tuberculosis (TB) involving the whole spine is very rare. So far, only 3 cases have been reported. PATIENT CONCERNS: We report a rare case of skipped multifocal extensive TB involving the whole spine of a 33-year-old Chinese male. The patient had been asymptomatic until his symptom was significantly aggravated, which caused him to have difficulty in walking and sleeping. The whole spinal computed tomography (CT) scan showed multifocal worm-eaten and osteolytic bony destruction spread over noncontiguous multilevel vertebral involvement in cervical, thoracic, lumbar, and sacral...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29498369/-abscesses-in-the-lumbo-sacral-spine-area-a-case-report
#20
Alicja Baranowska, Paweł Baranowski, Tadeusz Płusa
Infection of the surgical operation site is found in approximately 3% of patients and 20% of patients undergoing urgent surgery. The occurrence of this type of complications is affected both by coexisting diseases and the presence of infection in the environment in which the patient is staying. It should also be taken into account that the bacteria found in the implanted material and surrounding tissues have the ability to adhere to the implant, creating a biofilm structure there. The presented patient is an illustration of such a problem, because after L5 laminectomy and extensive L2-L3 and L3-L4 one-sided fenestration and L2-L3-L4-L5 facetectomy, interbody bone arthrodesis and transpedicular stabilization, he reported for fever and pain in right lumbar area...
February 23, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
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