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Updated: Aug 11, 2025
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
Tetra-compartmental spinal infection with conus medullaris syndrome: illustrative case
Edward G Andrews1, Jasmine L Hect1, Aditya M Mittal1
1Departments of1Neurosurgery and.
Background:
Recent literature suggests that spinal infections are increasing in prevalence. Any compartment can be infected in the spine; however, multicompartmental infections are rare.
Observations:
To the authors' knowledge, this report is the only reported case of a tetra-compartmental spinal infection consisting of epidural, subdural, subarachnoid, and intramedullary components with a contiguous lumbar spondylodiscitis resulting in conus medullaris syndrome requiring surgical intervention.
Lessons:
This case highlights the importance of surgical intervention in severe cases such as the one illustrated in this report. Second, magnetic resonance imaging with and without contrast is required to check for spreading of the infection as these findings may change the surgical approach. Last, the use of intraoperative ultrasound is paramount to evaluate the subdural and intramedullary compartments in severe cases.
Insights
This rare case of a tetra-compartmental spinal infection highlights the need for surgical intervention. Advanced imaging and intraoperative ultrasound are crucial for diagnosing and treating severe spinal infections.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Spinal Medicine
Background:
- Spinal infections are increasingly prevalent.
- Multicompartmental spinal infections are rare.
Purpose of the Study:
- To report a unique case of a tetra-compartmental spinal infection.
- To emphasize the diagnostic and therapeutic challenges posed by such infections.
Main Methods:
- Case report of a patient with epidural, subdural, subarachnoid, and intramedullary infection.
- Contiguous lumbar spondylodiscitis leading to conus medullaris syndrome.
- Surgical intervention was required.
Main Results:
- The case involved a rare tetra-compartmental spinal infection.
- Conus medullaris syndrome developed due to the infection.
- Surgical intervention was necessary.
Conclusions:
- Surgical intervention is crucial for severe spinal infections.
- Magnetic resonance imaging with contrast is essential for assessing infection spread and guiding surgical approach.
- Intraoperative ultrasound aids in evaluating subdural and intramedullary compartments in severe cases.
