eMedicine Specialties > Orthopedic Surgery > Spine

Spinal Infections: Multimedia

Author: Federico C Vinas, MD, Consulting Neurosurgeon, Department of Neurological Surgery, Halifax Medical Center
Coauthor(s): J Richard Rhodes, MD, Orthopedic Surgeon, Atlantic Orthopaedics, PA, and Coastal Medical Research; Amy L Stumpf, MPH, PA-C, Clinical Director, Assistant Professor, Physician Assistant Program, Nova Southeastern University
Contributor Information and Disclosures

Updated: Nov 3, 2008

Multimedia

Spinal infections. Lateral plain radiographs of a...
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Media file 1: Spinal infections. Lateral plain radiographs of a patient with diskitis at C4-5. Note the severe disk space narrowing and subluxation seen at C4-5.
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Spinal infections. Lateral plain radiographs of a...

Spinal infections. Lateral plain radiographs of a patient with diskitis at C4-5. Note the severe disk space narrowing and subluxation seen at C4-5.

Spinal infections. T2-weighted MRI of the patient...
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Media file 2: Spinal infections. T2-weighted MRI of the patient in Image 1. Evidence of osteomyelitis and diskitis, as well as a small epidural abscess, is present. The patient underwent a C4-5 anterior cervical diskectomy and arthrodesis using autologous iliac crest bone raft and instrumental fixation with a titanium plate and screws.
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Spinal infections. T2-weighted MRI of the patient...

Spinal infections. T2-weighted MRI of the patient in Image 1. Evidence of osteomyelitis and diskitis, as well as a small epidural abscess, is present. The patient underwent a C4-5 anterior cervical diskectomy and arthrodesis using autologous iliac crest bone raft and instrumental fixation with a titanium plate and screws.

Spinal infections. A 47-year-old woman who presen...
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Media file 3: Spinal infections. A 47-year-old woman who presented with intractable back pain. Radiographs reveal significant collapse and destruction of the L4 vertebral body. An MRI of the lumbar spine was ordered.
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Spinal infections. A 47-year-old woman who presen...

Spinal infections. A 47-year-old woman who presented with intractable back pain. Radiographs reveal significant collapse and destruction of the L4 vertebral body. An MRI of the lumbar spine was ordered.

An MRI of the patient in Image 3 reveals an enhan...
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Media file 4: An MRI of the patient in Image 3 reveals an enhancing mass affecting the L4 vertebral body with compromise of the spinal canal. The patient underwent several blood cultures and a CT-guided trocar biopsy; culture results were negative. A surgical procedure was necessary.
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An MRI of the patient in Image 3 reveals an enhan...

An MRI of the patient in Image 3 reveals an enhancing mass affecting the L4 vertebral body with compromise of the spinal canal. The patient underwent several blood cultures and a CT-guided trocar biopsy; culture results were negative. A surgical procedure was necessary.

Spinal infections. The patient from Images 3-4 de...
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Media file 5: Spinal infections. The patient from Images 3-4 developed lower extremity weakness, and follow-up studies reveal further compression of L4 and compromise of the canal. An anterolateral approach was performed with a corpectomy, decompression of the spinal canal, restoration of the anterior column support, and arthrodesis with a titanium cage and autologous iliac crest bone graft. The pathology and Gram stain revealed some hyphae. Culture findings were positive for Aspergillus species. The patient underwent a full course of amphotericin B and completely recovered.
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Spinal infections. The patient from Images 3-4 de...

Spinal infections. The patient from Images 3-4 developed lower extremity weakness, and follow-up studies reveal further compression of L4 and compromise of the canal. An anterolateral approach was performed with a corpectomy, decompression of the spinal canal, restoration of the anterior column support, and arthrodesis with a titanium cage and autologous iliac crest bone graft. The pathology and Gram stain revealed some hyphae. Culture findings were positive for Aspergillus species. The patient underwent a full course of amphotericin B and completely recovered.

More on Spinal Infections

Overview: Spinal Infections
Workup: Spinal Infections
Treatment: Spinal Infections
Follow-up: Spinal Infections
Multimedia: Spinal Infections
References
Further Reading
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Further Reading

Procedure guideline for 111in-leukocyte scintigraphy for suspected infection/inflammation.
Society of Nuclear Medicine.  1999 Feb (revised 2004 Jun 2).  6 pages.  NGC:004261
 
Procedure guideline for 99m Tc-Exametazime (HMPAO)-labeled leukocyte scintigraphy for suspected infection/inflammation.
Society of Nuclear Medicine.  1999 Feb (revised 2004 Jun 2).  6 pages.  NGC:004260

Procedure guideline for gallium scintigraphy in inflammation.
Society of Nuclear Medicine.  1999 Feb (revised 2004 Jun 2).  5 pages.  NGC:004259

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Keywords

spinal infections, pyogenic vertebral osteomyelitis, vertebral infection, bacterial osteomyelitis, infectious osteomyelitis, pyogenic vertebral infections, diskitis, epidural abscess

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Contributor Information and Disclosures

Author

Federico C Vinas, MD, Consulting Neurosurgeon, Department of Neurological Surgery, Halifax Medical Center
Federico C Vinas, MD is a member of the following medical societies: American Association of Neurological Surgeons, American College of Surgeons, American Medical Association, Congress of Neurological Surgeons, Florida Medical Association, and North American Spine Society
Disclosure: Nothing to disclose.

Coauthor(s)

J Richard Rhodes, MD, Orthopedic Surgeon, Atlantic Orthopaedics, PA, and Coastal Medical Research
J Richard Rhodes, MD is a member of the following medical societies: Florida Medical Association and Florida Orthopaedic Society
Disclosure: Nothing to disclose.

Amy L Stumpf, MPH, PA-C, Clinical Director, Assistant Professor, Physician Assistant Program, Nova Southeastern University
Disclosure: Nothing to disclose.

Medical Editor

James F Kellam, MD, Vice-Chair, Department of Orthopedic Surgery, Director of Orthopedic Trauma and Education, Carolinas Medical Center
James F Kellam, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Orthopaedic Trauma Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

William O Shaffer, MD, Professor, Vice-Chairman and Residency Program Director, Department of Orthopedic Surgery, University of Kentucky at Lexington
William O Shaffer, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, International Society for the Study of the Lumbar Spine, Kentucky Medical Association, Kentucky Orthopaedic Society, North American Spine Society, Southern Medical Association, and Southern Orthopaedic Association
Disclosure: DePuySpine 1997-2007 (not presently) Royalty Consulting; DePuySpine 2002-2007 (closed) Grant/research funds SacroPelvic Instrumentation Biomechanical Study; DePuyBiologics 2005-2008 (closed) Grant/research funds Healos study just closed; No present Industry grants or funds. None None

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Mary Ann E Keenan, MD, Professor, Vice Chair for Graduate Medical Education, Department of Orthopedic Surgery, University of Pennsylvania School of Medicine; Chief of Neuro-Orthopedics Program, Department of Orthopedic Surgery, Hospital of the University of Pennsylvania
Mary Ann E Keenan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, American Society for Surgery of the Hand, and Orthopaedic Rehabilitation Association
Disclosure: Nothing to disclose.

 
 
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