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Discitis and isthmic spondylolisthesis: a case report.
Yossi Smorgick1, Yizhar Floman, Yoram Anekstein
1Department of Orthopedic Surgery, Assaf Harofeh Medical Center, Zerifin, Israel. Noam_Yossi@Yahoo.com
Journal of Pediatric Orthopedics. Part B
|November 29, 2007
Summary
This case report details a rare instance of coexisting spondylolisthesis and disc space infection in a pediatric patient. Nonoperative treatment led to spontaneous fusion and symptom resolution, allowing a return to sports.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
- Spinal Surgery
Background:
- Spondylolysis and spondylolisthesis are frequent causes of pediatric low back pain.
- Disc space infection is a less common but severe cause of back pain in adolescents.
- The simultaneous occurrence of both conditions in the same spinal segment is exceptionally rare.
Observation:
- A 13-year-old male presented with severe low back pain.
- Radiological imaging revealed isthmic lumbosacral spondylolisthesis with endplate irregularities and an anterior bridging osteophyte.
- The patient was diagnosed with a disc space infection at the level of the spondylolisthesis.
Findings:
- The patient underwent a 6-week course of intravenous antibiotics, followed by 2 weeks of oral medication.
- At 28-week follow-up, spontaneous radiological fusion at the affected spinal segment was observed.
- Complete symptom relief was achieved, enabling the patient to resume sports activities.
Implications:
- Isthmic spondylolisthesis and disc space infection can coexist in pediatric patients.
- Nonoperative management, including antibiotics, can be effective in treating this combined condition.
- Successful treatment can lead to spontaneous spinal fusion and full recovery, allowing return to physical activities.
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