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Case of osteomyelitis caused by Cutibacterium acnes after full-endoscopic spinal surgery
Saori Takeuchi1, Satoru Yabuno1, Masatoshi Yunoki1
1Department of Neurosurgery, Kagawa Rosai Hospital, Marugame, Japan.
Background:
Full-endoscopic spinal surgery (FESS) is an effective technique for reducing the risk of surgical site infection. However, postoperative infections do occur but are only rarely reported.
Case Description:
A 71-year-old male underwent a left L45 FESS for foraminal stenosis and disc herniation. Postop day 40, he developed the sudden onset of severe low back pain/sciatica. Although he remained afebrile and laboratory tests showed only mild inflammation (C-reactive protein: 2.1 mg/dL, white blood cell count within the normal range), the lumbar magnetic resonance and computed tomography (CT) studies revealed L4/5 osteomyelitis. The CT-guided biopsy documented Cutibacterium acnes (formerly Propionibacterium acnes), and the patient responded well to antibiotic treatment alone, without requiring additional surgical intervention.
Conclusion:
This case describes the 40-day delayed postoperative-onset of osteomyelitis following a right L45 FESS caused by C. acnes.
Insights
Delayed osteomyelitis, a rare complication of full-endoscopic spinal surgery (FESS), can occur weeks after the procedure. This case highlights Cutibacterium acnes as a cause, treatable with antibiotics alone.
Area of Science:
- Spinal Surgery
- Infectious Diseases
- Orthopedics
Background:
- Full-endoscopic spinal surgery (FESS) is recognized for its potential to minimize surgical site infections.
- Despite its benefits, postoperative infections following FESS, though rare, can still occur.
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