Postoperative Spondylodiscitis in a Patient With Ankylosing Spondylitis Diaphragmatic Rupture

Year 2015, , 218 - 222, 27.08.2015

Ümit Yalçın Şebnem Koldaş Doğan Tuncay Çakır Naciye Füsun Toraman Sevtap Badil İlhan Sezer

https://doi.org/10.18229/ktd.41732

Abstract

In this case we present a patient with ankylosing spondylitis for 35 years who had spondylodiscitis after right total hip replacement operation. After right total hip replacement operation, patient had a progressive paraparesis of lower extremity, advanced to paraplegia, so we performed a thoracic magnetic resonance imaging which had spondylodiscitis with spinal cord compression at thoracic 11-12 vertebra levels. The patient is hospitalised for rehabilitation after T11 total laminectomy+- costotransversectomy. We couldn’t find any etiologic factor after our examination. Patient was discharged with better muscle strength with double crutches. We presented this case to remind spondylodiscitis after surgery and spondylodiscitis as a complication of ankylosing spondylitis.

Keywords

Ankylosing spondylitis, postoperative spondylodiscitis, total hip arthroplasty

Ankilozan Spondilit Tanılı Hastada Postoperatif Gelişen Spondilodiskit

Abstract

Bu olguda ankilozan spondilit tanısı olan, koksartroz nedeniyle sağ total kalça protezi cerrahisi geçirdikten sonra spondilodiskit gelişen hasta sunulmuştur. Cerrahi sonrası bacaklarda kuvvetsizlik, hareketle artan şiddetli bel ağrısı oluşan hastada parapleji gelişmesi sonucu çekilen manyetik rezonans görüntülemede torakal 11-12 vertebralar seviyesinde korda bası yapan spondilodiskit tespit edilmiş olup, hastaya T11 total laminektomi+kostatransversektomi uygulanıp, rehabilitasyon amaçlı servisimize yatırılmıştır. Etiyolojik bir neden bulunamamıştır. Tedavi sonrası alt ekstremite kas kuvvetleri dü- zelen hasta çift kanedyenle mobilize bir şekilde taburcu edilmiştir. Bu olguyu, cerrahi sonrası şiddetli bel ağrısı ve kas gücü kaybında tanı olarak spondilodiskiti de düşünmemiz ve ankilozan spondilitli hastalarda spondilodiskit komplikasyonunu hatırlatmak için hazırladık.

Keywords

Ankilozan spondilit, postoperatif spondilodiskit, total kalça protezi

References

• Atan Ç, Seçkin Ü, Bodur H. Ankilozan spondilite bağlı spondilodiskit. Turk J Phys Med Rehab 2008;54(2):77-8.
• Bavinzski G, Scheggl A, Trattnig S, et al. Microsurgical management of postoperative disc space infection. Neurosurg Rev. 2003; 26:102-7,
• Toussirot E, Chataiqner H, Pepin L, et al. Spinal cord compression complicating aseptic spondylodiscitis in ankylosing spondylitis. Clin Exp Rheumatol. 2009;27(4):654-7.
• Friedman JA, Maher CO, Quast LM, et al. Spontaneous disc space infections in adults. Surg Neurol 2002;57(2): 81-6.
• Hopkinson N, Stevenson J, Benjamin S. A case ascertainment study of septic discitis: clinical, microbiological and radiological features. QJM 2001;94(9):465-470.
• Jimenez-Mejias ME, De Dios Colmenero J, Sanchez-Lora FJ, et al. Postoperative spondylodiskitis: etiology, clinical findings, prognosis, and comparison with nonoperative pyogenic spondylodiskitis. Clin Infect Dis infection. In: Batjer HH, Loftus CM (Editors). Textbook of neurological surgery.New York: Wolters Kluwer, 2003;3224-38.
• Mastronardi L, Rychlicki F, Tatta C, et al. Spondylodiscitis after lumbar microdiscectomy: effectiveness of two protocols of intraoperative antibiotic prophylaxis in 1167 cases. Neurosurg Rev 2005;28:303-7.
• Fouquet B, Goupille P, Jattiot F, et al. Discitis Silber JS, Anderson DG, Vaccaro AR, et al. Gouliouris T. Spondylodiscitis: update on diagnosis and management. J Antimic Chemotherapy 2010;65( suppl 3):11-24.
• Rasker JJ, Prevo RL, Lanting PJ. Spondylodiscitis in ankylosing spondylitis, inflammation or trauma? A description of six cases. Scand J Rheumatol 1996;25(1):52-7.
• Asamoto S, Doi H, Kobayashi N, et al. Spondylodiscitis: diagnosis and treatment. Surg Neurol 2005;64(2):103-8.