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CT fluoroscopy-guided percutaneous intervertebral drain insertion for cervical pyogenic spondylodiscitis
Kosuke Tomita1, Tomohiro Matsumoto1, Masahiro Kamono2
1Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Hachioji, Tokyo, Japan.
Diagnostic and Interventional Radiology (Ankara, Turkey)
|February 18, 2021
Summary
A novel lateral approach for CT fluoroscopy-guided drain insertion effectively treated cervical pyogenic spondylodiscitis. This technique overcomes anatomical challenges, offering a safe option for this rare spinal infection.
Area of Science:
- Neurosurgery
- Radiology
- Infectious Disease
Background:
- Cervical pyogenic spondylodiscitis with epidural abscess presents unique challenges for intervertebral drain insertion due to narrow spaces and complex anatomy.
- Traditional posterolateral computed tomography (CT)-guided percutaneous drainage is not feasible in the cervical spine because of the vertebral artery and uncinate processes.
Observation:
- A 79-year-old male patient with C6-C7 pyogenic spondylodiscitis and an epidural abscess required intervention.
- The limitations of standard CT-guided drainage necessitated exploring alternative approaches.
Findings:
- A CT fluoroscopy-guided lateral approach was successfully employed for percutaneous cervical intervertebral drain insertion.
- The needle was advanced between the carotid sheath and scalene muscle, with simultaneous intravenous contrast enhancement.
- This technique proved safe and effective in managing the cervical infection, a procedure not previously documented.
Implications:
- This lateral approach represents a potentially safe and useful technique for treating cervical pyogenic spondylodiscitis.
- It expands interventional options for spinal infections in challenging anatomical regions.
- Further studies are warranted to validate this minimally invasive technique in a broader patient cohort.
