BACKGROUND A high degree of vigilance is warranted for a spinal infection,particularly in a patient who has undergone an invasive procedure such as a spinal injection.The average delay in diagnosing a spinal infection...BACKGROUND A high degree of vigilance is warranted for a spinal infection,particularly in a patient who has undergone an invasive procedure such as a spinal injection.The average delay in diagnosing a spinal infection is 2-4 mo.In our patient,the diagnosis of a spinal infection was delayed by 1.5 mo.CASE SUMMARY A 60-year-old male patient with a 1-year history of right-sided lumbar radicular pain failed conservative treatment.Six weeks to prior to surgery he received a spinal injection,which was followed by increasing lumbar radicular pain,weight loss and chills.This went unnoticed and surgery took place with right-sided L4-L5 combined microdiscectomy and foraminotomy via a posterior approach.The day after surgery,the patient developed left-sided lumbar radicular pain.Blood cultures grew Staphylococcus aureus(S.aureus).Magnetic resonance imaging showed inflammatory aberrations,revealing septic arthritis of the left-sided L4/L5 facet joint as the probable cause.Revision surgery took place and S.aureus was isolated from bacteriological samples.The patient received postoperative antibiotic treatment,which completely eradicated the infection.CONCLUSION The development of postoperative lower back pain and/or lumbar radicular pain can be a sign of a spinal infection.A thorough clinical and laboratory work-up is essential in the preoperative evaluation of patients with spinal pain.展开更多
Since the outbreak of coronavirus disease 2019(COVID-19)in December 2019 in China,various measures have been adopted in order to attenuate the impact of the virus on the population.With regard to spine surgery,French ...Since the outbreak of coronavirus disease 2019(COVID-19)in December 2019 in China,various measures have been adopted in order to attenuate the impact of the virus on the population.With regard to spine surgery,French physicians are devoted to take place in the national plan against COVID-19,the French Spine Surgery Society therefore decided to elaborate specific guidelines for management of spinal disorders during COVID-19 pandemic in order to prioritize management of patients.A three levels stratification was elaborated with Level I:Urgent surgical indications,Level II:Surgical indications associated to a potential loss of chance for the patient and Level III:Non-urgent surgical indications.We also report French experience in a COVID-19 cluster region illustrated by two clinical cases.We hope that the guidelines formulated by the French Spine Surgery Society and the experience of spine surgeons from a cluster region will be helpful in order optimizing the management of patients with urgent spinal conditions during the pandemic.展开更多
文摘BACKGROUND A high degree of vigilance is warranted for a spinal infection,particularly in a patient who has undergone an invasive procedure such as a spinal injection.The average delay in diagnosing a spinal infection is 2-4 mo.In our patient,the diagnosis of a spinal infection was delayed by 1.5 mo.CASE SUMMARY A 60-year-old male patient with a 1-year history of right-sided lumbar radicular pain failed conservative treatment.Six weeks to prior to surgery he received a spinal injection,which was followed by increasing lumbar radicular pain,weight loss and chills.This went unnoticed and surgery took place with right-sided L4-L5 combined microdiscectomy and foraminotomy via a posterior approach.The day after surgery,the patient developed left-sided lumbar radicular pain.Blood cultures grew Staphylococcus aureus(S.aureus).Magnetic resonance imaging showed inflammatory aberrations,revealing septic arthritis of the left-sided L4/L5 facet joint as the probable cause.Revision surgery took place and S.aureus was isolated from bacteriological samples.The patient received postoperative antibiotic treatment,which completely eradicated the infection.CONCLUSION The development of postoperative lower back pain and/or lumbar radicular pain can be a sign of a spinal infection.A thorough clinical and laboratory work-up is essential in the preoperative evaluation of patients with spinal pain.
文摘Since the outbreak of coronavirus disease 2019(COVID-19)in December 2019 in China,various measures have been adopted in order to attenuate the impact of the virus on the population.With regard to spine surgery,French physicians are devoted to take place in the national plan against COVID-19,the French Spine Surgery Society therefore decided to elaborate specific guidelines for management of spinal disorders during COVID-19 pandemic in order to prioritize management of patients.A three levels stratification was elaborated with Level I:Urgent surgical indications,Level II:Surgical indications associated to a potential loss of chance for the patient and Level III:Non-urgent surgical indications.We also report French experience in a COVID-19 cluster region illustrated by two clinical cases.We hope that the guidelines formulated by the French Spine Surgery Society and the experience of spine surgeons from a cluster region will be helpful in order optimizing the management of patients with urgent spinal conditions during the pandemic.
