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Pyogenic vertebral osteomyelitis of the posterior elements
T J Babinchak1, D K Riley, E B Rotheram
1Division of Infectious Diseases, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA.
Abstract:
Lone pyogenic involvement of the posterior elements of the vertebrae is a rare event. We present two cases of isolated lumbar vertebral infection of the posterior elements and review 13 cases previously reported in the literature. Clinical presentation, laboratory and radiographic findings, microbiological etiology, and treatment were evaluated. Back pain, an elevated erythrocyte sedimentation rate, and computed tomography or magnetic resonance imaging were most useful in identifying the presence and extent of infection. Antibiotic therapy with or without surgical intervention was successful in all cases.
Insights
Isolated pyogenic infection of the lumbar spine posterior elements is rare. This study highlights key diagnostic factors and successful treatment outcomes with antibiotics and/or surgery for this vertebral infection.
Area of Science:
- Orthopedics
- Infectious Diseases
- Radiology
Background:
- Pyogenic vertebral osteomyelitis (PVO) is a serious spinal infection.
- Isolated involvement of the posterior elements of the vertebrae is uncommon.
- This study focuses on lumbar spine posterior element infections.
Observation:
- Presents two new cases of isolated lumbar posterior element infection.
- Reviews 13 previously reported cases from the literature.
- Evaluates clinical presentation, laboratory results, imaging findings, and microbiology.
Findings:
- Back pain and elevated erythrocyte sedimentation rate (ESR) are key indicators.
- Computed tomography (CT) and magnetic resonance imaging (MRI) are crucial for diagnosis and staging.
- Common microbiological causes include Staphylococcus aureus.
Implications:
- Early diagnosis relies on clinical suspicion and advanced imaging.
- Prompt antibiotic therapy is essential for successful treatment.
- Surgical intervention may be necessary in some cases, but conservative management is often effective.