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Research ArticleLumbar Spine

Osteomyelitis-Discitis at the Thoracolumbar Junction and the Development of Postinfectious Spinal Deformity: A Surgical Case Series

TERENCE VERLA, ROBERT NORTH, VENITA SIMPSON and ALEXANDER E. ROPPER
International Journal of Spine Surgery August 2020, 14 (4) 552-558; DOI: https://doi.org/10.14444/7073
TERENCE VERLA
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
MD
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ROBERT NORTH
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
MD, PHD
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VENITA SIMPSON
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
MD
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ALEXANDER E. ROPPER
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
MD
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    Figure 1

    Distribution of patients in the study.

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    Figure 2

    (Ai) Images at initial diagnosis of osteomyelitis-discitis at L1 to L2 with epidural component and compression of neural elements—initial plan for urgent decompression. (Aii) Status after L1 to L2 laminectomy, now with progression of kyphosis. (Aiii) Status after instrumentation and fusion for correction of deformity. (Bi) Images at initial diagnosis of osteomyelitis-discitis at T12 to L1 with minimal epidural component—initial plan to medically manage. (Bii) Status after 8 weeks of antibiotic treatment only, now with progressive kyphotic deformity and neurologic decline. (Biii) Status after instrumentation and fusion for correction of deformity.

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    Figure 3

    Risk Factors for Instrumentation: Laminectomy, Epidural Compression and Vertebral body collapse

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    Figure 4

    Time to kyphosis progression requiring surgical intervention in patients initially managed medically and with laminectomy

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    Figure 5

    Changes in segmental kyphosis in the medical management only group and in surgical group with resultant improvement in angle of segmental kyphosis after instrumentation

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International Journal of Spine Surgery
Vol. 14, Issue 4
1 Aug 2020
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Osteomyelitis-Discitis at the Thoracolumbar Junction and the Development of Postinfectious Spinal Deformity: A Surgical Case Series
TERENCE VERLA, ROBERT NORTH, VENITA SIMPSON, ALEXANDER E. ROPPER
International Journal of Spine Surgery Aug 2020, 14 (4) 552-558; DOI: 10.14444/7073

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Osteomyelitis-Discitis at the Thoracolumbar Junction and the Development of Postinfectious Spinal Deformity: A Surgical Case Series
TERENCE VERLA, ROBERT NORTH, VENITA SIMPSON, ALEXANDER E. ROPPER
International Journal of Spine Surgery Aug 2020, 14 (4) 552-558; DOI: 10.14444/7073
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Keywords

  • osteomyelitis
  • thoraco-lumbar junction
  • spine fusion
  • spinal deformity

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