BACKGROUND Chronic neck pain is a common clinical problem.It has long been considered that degenerative cervical disc is an important source of chronic neck pain.In the clinic,cervical discography is thought to be a u...BACKGROUND Chronic neck pain is a common clinical problem.It has long been considered that degenerative cervical disc is an important source of chronic neck pain.In the clinic,cervical discography is thought to be a useful and safe method to distinguish aging discs from pathological discs,and the probability of complications caused by it is really rare.However,once complication occurs,it is likely to cause fatal consequences to patients.Therefore,accurate judgment and effective treatment are crucial.CASE SUMMARY A 45-year-old female was admitted to the department with a 5-year history of severe neck pain,dizziness,and tinnitus.In order to find the diseased disc,analgesic discography was performed on C4/5 and 6/7 discs successively.Unfortunately,Discitis with an epidural abscess was caused during the procedures.With the help of magnetic resonance imaging,an accurate diagnosis was made and an urgent anterior cervical operation was given subsequently.The patient ultimately recovered well.CONCLUSION Discitis with epidural abscess is a rare complication after cervical discography,which needs accurate diagnosis and effective antibiotic treatment.展开更多
To the Editor： Calcific discitis is a self-limiting cervical disc disease usually seen in children and uncommon in adults.[1] It can typically be cured by conservative treatment.[2] In this article, we reported a cas...To the Editor： Calcific discitis is a self-limiting cervical disc disease usually seen in children and uncommon in adults.[1] It can typically be cured by conservative treatment.[2] In this article, we reported a case of paralysis caused by thoracolumbar calcific discitis, with acute herniation.展开更多
Postoperative surgical site infection(SSI) is a common complication after posterior lumbar spine surgery. This review details an approach to the prevention,diagnosis and treatment of SSIs. Factors contributing to the ...Postoperative surgical site infection(SSI) is a common complication after posterior lumbar spine surgery. This review details an approach to the prevention,diagnosis and treatment of SSIs. Factors contributing to the development of a SSI can be split into three categories:(1) microbiological factors;(2) factors related to the patient and their spinal pathology; and(3) factors relating to the surgical procedure. SSI is most commonly caused by Staphylococcus aureus. The virulence of the organism causing the SSI can affect its presentation. SSI can be prevented by careful adherence to aseptic technique,prophylactic antibiotics,avoiding myonecrosis by frequently releasing retractors and preoperatively optimizing modifiable patient factors. Increasing pain is commonly the only symptom of a SSI and can lead to a delay in diagnosis. C-reactive protein and magnetic resonance imaging can help establish the diagnosis. Treatment requires acquiring intra-operative cultures to guide future antibiotic therapy and surgical debridement of all necrotic tissue. A SSI can usually be adequately treated without removing spinalinstrumentation. A multidisciplinary approach to SSIs is important. It is useful to involve an infectious disease specialist and use minimum serial bactericidal titers to enhance the effectiveness of antibiotic therapy. A plastic surgeon should also be involved in those cases of severe infection that require repeat debridement and delayed closure.展开更多
Background: We describe a rare case of Candida albicans retropharyngeal infection with upper cervical spondylodiscitis associated with epidural abscess triggered by ingestion of a chicken bone. Case Description: A 63-...Background: We describe a rare case of Candida albicans retropharyngeal infection with upper cervical spondylodiscitis associated with epidural abscess triggered by ingestion of a chicken bone. Case Description: A 63-year-old woman presented with posterior neck and bilateral shoulders pain three weeks after choking on a 2-centimeter chicken bone. Magnetic resonance imaging (MRI) revealed spondylodiscitis and epidural abscess with significant spinal cord compression at C2 and C3 levels. A Barium swallow showed a focal disruption of the posterior wall of the esophagus. A posterior upper cervical fixation (C2-C5) was initially performed. One week later an anterior decompressive procedure was carried out followed by iliac crest bony fusion, and repair of the esophageal defect. Intra-operative cultures showed heavy growth of Candida albicans. After a transitory post-operative neurologic worsening, and after six weeks of appropriate antifungal therapy, the patient achieved a full clinical and radiologic recovery. Conclusion: Prompt surgical debridement, fusion and stabilization combined with adequate antimicrobial agents are necessary to guarantee a good outcome and reverse the neurological deficits.展开更多
基金Supported by Foundation of Capital Medical Development,Beijing,China,No.2010026.
文摘BACKGROUND Chronic neck pain is a common clinical problem.It has long been considered that degenerative cervical disc is an important source of chronic neck pain.In the clinic,cervical discography is thought to be a useful and safe method to distinguish aging discs from pathological discs,and the probability of complications caused by it is really rare.However,once complication occurs,it is likely to cause fatal consequences to patients.Therefore,accurate judgment and effective treatment are crucial.CASE SUMMARY A 45-year-old female was admitted to the department with a 5-year history of severe neck pain,dizziness,and tinnitus.In order to find the diseased disc,analgesic discography was performed on C4/5 and 6/7 discs successively.Unfortunately,Discitis with an epidural abscess was caused during the procedures.With the help of magnetic resonance imaging,an accurate diagnosis was made and an urgent anterior cervical operation was given subsequently.The patient ultimately recovered well.CONCLUSION Discitis with epidural abscess is a rare complication after cervical discography,which needs accurate diagnosis and effective antibiotic treatment.
文摘To the Editor： Calcific discitis is a self-limiting cervical disc disease usually seen in children and uncommon in adults.[1] It can typically be cured by conservative treatment.[2] In this article, we reported a case of paralysis caused by thoracolumbar calcific discitis, with acute herniation.
文摘Postoperative surgical site infection(SSI) is a common complication after posterior lumbar spine surgery. This review details an approach to the prevention,diagnosis and treatment of SSIs. Factors contributing to the development of a SSI can be split into three categories:(1) microbiological factors;(2) factors related to the patient and their spinal pathology; and(3) factors relating to the surgical procedure. SSI is most commonly caused by Staphylococcus aureus. The virulence of the organism causing the SSI can affect its presentation. SSI can be prevented by careful adherence to aseptic technique,prophylactic antibiotics,avoiding myonecrosis by frequently releasing retractors and preoperatively optimizing modifiable patient factors. Increasing pain is commonly the only symptom of a SSI and can lead to a delay in diagnosis. C-reactive protein and magnetic resonance imaging can help establish the diagnosis. Treatment requires acquiring intra-operative cultures to guide future antibiotic therapy and surgical debridement of all necrotic tissue. A SSI can usually be adequately treated without removing spinalinstrumentation. A multidisciplinary approach to SSIs is important. It is useful to involve an infectious disease specialist and use minimum serial bactericidal titers to enhance the effectiveness of antibiotic therapy. A plastic surgeon should also be involved in those cases of severe infection that require repeat debridement and delayed closure.
文摘Background: We describe a rare case of Candida albicans retropharyngeal infection with upper cervical spondylodiscitis associated with epidural abscess triggered by ingestion of a chicken bone. Case Description: A 63-year-old woman presented with posterior neck and bilateral shoulders pain three weeks after choking on a 2-centimeter chicken bone. Magnetic resonance imaging (MRI) revealed spondylodiscitis and epidural abscess with significant spinal cord compression at C2 and C3 levels. A Barium swallow showed a focal disruption of the posterior wall of the esophagus. A posterior upper cervical fixation (C2-C5) was initially performed. One week later an anterior decompressive procedure was carried out followed by iliac crest bony fusion, and repair of the esophageal defect. Intra-operative cultures showed heavy growth of Candida albicans. After a transitory post-operative neurologic worsening, and after six weeks of appropriate antifungal therapy, the patient achieved a full clinical and radiologic recovery. Conclusion: Prompt surgical debridement, fusion and stabilization combined with adequate antimicrobial agents are necessary to guarantee a good outcome and reverse the neurological deficits.
