Adjacent level spondylodiscitis in a patient with thoracic spondylodiscitis: A case report and review of the literature.

INTRODUCTION: Adjacent level spondylodiscitis (ALS) after primary surgery for thoracic spondylodiscitis is a very rare condition.

CASE REPORT: We report the case of a 76-year-old man with this pathology. A first posterior minimally invasive approach combined with anterior approach to the thoracic spine was safely performed for thoracic spondylodiscitis. More than a year later, exploration of recurrent symptoms with 18 FDG PET scan helped to diagnose ALS. Further surgery was performed. At 3-year follow-up examination showed no recurrence of the infection.

DISCUSSION: ALS should be suspected during recurrent symptoms after spinal fusion surgery. Evaluation should be based on the results of 18 FDG PET scan and surgery.

CONCLUSION: Bacterial and histopathological analyses combined with an increase of spine fixation and adapted antimicrobial therapy are a safe management for ALS.