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Epidural abscess of the cervical spine with osteomyelitis of the odontoid process
M Wiedau-Pazos1, G Curio, C Grüsser
1Department of Neurology, Klinikum Benjamin Franklin, Freie Universität Berlin, Germany. wiedau@neon.chem.ucla.edu
Study Design:
A case report.
Objectives:
To document the rare condition of staphylococcal osteomyelitis of the odontoid process and to increase knowledge about the clinical characteristics and favorable outcome if patients are managed appropriately.
Summary Of Background Data:
Osteomyelitis of the odontoid process caused by Staphylococcus aureus is a rare disease. A handful of cases have been reported within the last 30 years. Destructive odontoid peg involvement is most commonly associated with rheumatoid disease, which has a distinct clinical course compared with that of bacterial infection.
Methods:
Two patients with bacterial osteomyelitis of the odontoid peg underwent medical and surgical treatment. They were observed for 3 years. All authors were involved in the care of these patients.
Results:
Close monitoring of the patients' neurologic status and the use of noninvasive imaging techniques to evaluate the cervical spine led to an individualized treatment plan including antibiotic medication and transoral surgery with good outcomes in both cases.
Conclusions:
Awareness of the occurrence of bacterial osteomyelitis of the odontoid process, with or without neurologic symptoms, in patients with neck pain and fever may lead to earlier detection of this potentially critical condition, which has an excellent prognosis when treated early and appropriately.