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Vertebral augmentation-related Clostridium septicum osteomyelitis
Nicholas Pavlatos1, Matthew Kurian1, Omar Khan2
1Northeastern Ohio Medical University, Rootstown, OH, USA.
Radiology Case Reports
|August 15, 2022
Summary
Vertebral osteomyelitis, a rare complication of vertebral augmentation, occurred in a patient with Clostridium septicum infection. Prompt diagnosis and management are crucial to prevent severe outcomes.
Area of Science:
- Orthopedics
- Infectious Diseases
- Surgical Complications
Background:
- Vertebral augmentation (kyphoplasty/vertebroplasty) is a common treatment for compression fractures, particularly in osteoporotic patients.
- The procedure offers significant pain relief and functional improvement compared to other management options.
- While rare, infection is a serious potential complication of vertebral augmentation.
Observation:
- A case of vertebral osteomyelitis is presented following multiple vertebral augmentations.
- The patient presented insidiously with Clostridium septicum bacteremia and osteomyelitis.
- A history of hemorrhoidectomy four weeks prior to initial fracture presentation was noted.
Findings:
- Blood and intraoperative vertebral body cultures were positive for Clostridium septicum.
- The patient did not respond to prolonged intravenous antibiotics.
- Surgical intervention, including vertebral corpectomy and debridement with instrumentation, was required.
Implications:
- This case highlights the importance of thorough pre- and postoperative evaluation and follow-up after vertebral augmentation.
- Consideration of antibiotic prophylaxis is recommended for patients with recent gastrointestinal manipulation or surgery.
- Early recognition and management are vital to prevent severe consequences of post-procedural infections.
