Management of a post-operative multi-resistant infectious spondylitis associated with a kyphotic deformity

Felix Neumayer, Victor Kosmopoulos, Constantin Schizas

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Anterior spinal infection (prevertebral abscess and/or discitis) after posterior instrumentation for vertebral fractures is a challenging complication, since a new implant may become necessary anteriorly, in a septic environment. Generally accepted management guidelines are yet to be established. The authors present a case of posterior instrumentation for fractures of T12 and L1, complicated after 9 months with an anterior infection (prevertebral abscess and discitis) with extended-spectrum beta-lactamase (ESBL) producing Escherichia coli (E.coli). This case is unique in that the multi-resistant organism was isolated only after the second stage of infection treatment, which consisted of anterior debridement and anterior implantation of titanium cages and rods. In this particular case, infection was controlled despite implantation of multiple cages, screws and rods, and fusion was achieved, by means of intravenous antibiotic treatment for 12 months. At the latest follow-up, 24 months post surgery, there was no evidence of infection. This problem case may be helpful for surgeons confronted with spinal deformities secondary to infections with multi-resistant organisms.

Original languageEnglish
Pages (from-to)566-570
Number of pages5
JournalActa Orthopaedica Belgica
Volume75
Issue number4
StatePublished - 1 Aug 2009

Keywords

  • Extended-spectrum beta-lactamase (ESBL) producing Escherichia coli (E. coli)
  • Instrumentation
  • Kyphosis
  • Post-operative infection

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