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Spontaneous pyogenic facet joint infection.

Javier Narváez1, Joan M Nolla, José A Narváez

  • 1Rheumatology Department, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain. 31577edd@comb.es

Seminars in Arthritis and Rheumatism
|April 18, 2006
PubMed
Summary

Spontaneous pyogenic facet joint infection (PFJI) is more common than previously thought, representing 20% of spinal infections. Early diagnosis and medical treatment lead to good outcomes with low mortality.

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Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Neurosurgery

Background:

  • Spontaneous pyogenic facet joint infection (PFJI) is an uncommon spinal infection.
  • Understanding the clinical presentation, management, and outcomes of PFJI is crucial for timely diagnosis and treatment.

Purpose of the Study:

  • To analyze the clinical features, management approaches, and outcomes of spontaneous pyogenic facet joint infection (PFJI) in adults.
  • To determine the incidence and characteristics of PFJI in a tertiary care setting.

Main Methods:

  • A case series of 10 adult patients with microbiologically proven PFJI over 10 years.
  • Inclusion of 32 previously reported cases for a comprehensive analysis (total N=42).
  • Exclusion of patients with prior spinal instrumentation, surgery, or history of injection drug use.

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Main Results:

  • PFJI constitutes approximately 20% of all spontaneous pyogenic spinal infections.
  • The lumbosacral region was the most common site (86%), with severe back pain as the primary symptom.
  • Staphylococcus aureus was the predominant pathogen (86%), and bacteremia was common (81%).
  • Medical management alone was successful in most cases, with a low mortality rate (2%) and good functional recovery.

Conclusions:

  • PFJI is a significant cause of spinal infection, more prevalent than previously recognized.
  • Consider PFJI in the differential diagnosis of low back pain, especially with fever.
  • Prompt diagnosis and appropriate medical management are key to favorable outcomes in PFJI.