Video-assisted thoracoscopic surgery as a diagnostic and therapeutic instrument in non-tubercular spondylodiscitis

Spondylodiscitis refers to an infection of one or more intervertebral disks and vertebrae, most commonly caused by tuberculosis. Initial therapy for spondylodiscitis is drug treatment. Indications for surgical treatment include compression of neural elements, spinal instability or severe deformities. When surgery is indicated, an open technique is still the standard, although video-assisted thoracoscopic surgery (VATS) is described in cases of thoracic disk herniation, scoliosis and tubercular spondylitis.

We report a case of a 79-year-old man with progressive back pain, paraparesis and paresthesias in both legs. During assessment, spondylodiscitis with spinal cord compression was diagnosed. Immediate surgical decompression took place by means of VATS. Culture of the tissue obtained revealed Proteus mirabilis. Blood and urine cultures also revealed Proteus mirabilis, a rare cause of spondylodiscitis with an occurrence rate of 0.9%.

VATS offered a minimally invasive access to obtain the diagnosis of pyogenic spondylodiscitis following urosepsis with Proteus mirabilis. Moreover, it provided treatment with abscess drainage and decompression of the spinal cord.