Spondylodiscitis affecting the cervical spine is the most unusual type. Disease progression can be dramatic, even causing quadriplegia and death. We present an unusual case that progressed with osteolytic lesions between C2 and C3, causing cord compression and epidural abscess. The patient was treated surgically by a double approach and improved without neurological deficits and with better inflammatory markers. We reviewed the current literature on the subject.
Spondylodiscitis due to Candida is a rare complication from hematogenic dissemination of infection caused by this fungus. We present an atypical case of spondylodiscitis caused by this germ that occurred after chest contusion and progressed with necrotizing fasciitis of the anterior region of the chest and osteomyelitis of the sternum. Through contiguity, it also affected the upper thoracic spine. The patient evolved with neurological alterations and recovered satisfactorily after appropriate treatment with surgical decompression of the spinal cord and specific antibiotic therapy.
Figura 1 -Radiografia panorâmica de bacia em AP, mostrando diminuição do espaço articular à direita, além de achatamento da cabeça femoral ipsilateral.
Como citar este artigo: Kulcheski ÁL, et al. Espondilodiscite fúngica por Candida albicans: um caso atípico e revisão da literatura. Rev Bras Ortop. 2015. http://dx.doi.org/10.1016/j.rbo.2015.04.016 No. of Pages 4 r e v b r a s o r t o p . 2 0 1 5;x x x(x x):xxx-xxx w w w . r b o . o r g . b r Relato de caso Espondilodiscite fúngica por Candida albicans: um caso atípico e revisão da literatura ଝ informações sobre o artigo Histórico do artigo: Recebido em 18 de agosto de 2014 Aceito em 14 de novembro de 2014 On-line em xxx Palavras-chave: Candida albicans Discite Doenças da coluna vertebral r e s u m o A espondilodiscite por Candida albicans é uma rara complicação da disseminação hematogênica da infecção por esse fungo. Apresentamos um caso atípico de espondilodiscite por esse germe ocorrido após trauma contuso torácico que cursou com fasceíte necrotizante da região anterior do tórax, osteomielite de esterno e, por contiguidade, afetou a coluna vertebral torácica alta. O paciente evoluiu com alteração neurológica e recuperou--se satisfatoriamente após tratamento adequado com descompressão medular cirúrgica e antibioticoterapia específica. Discitis Spinal diseases a b s t r a c t Spondylodiscitis due to Candida is a rare complication from hematogenic dissemination of infection caused by this fungus. We present an atypical case of spondylodiscitis caused by this germ that occurred after chest contusion and progressed with necrotizing fasciitis of the anterior region of the chest and osteomyelitis of the sternum. Through contiguity, it also affected the upper thoracic spine. The patient evolved with neurological alterations and recovered satisfactorily after appropriate treatment with surgical decompression of the spinal cord and specific antibiotic therapy
ARTICLE IN PRESS
OBJECTIVE:The objective of this study is to compare the clinical outcome among patients who are surgically treated for lumbar disc herniation by transforaminal and interlaminar endoscopy techniques.
METHODS:For the treatment of lumbar disc herniation, 31 patients were assigned to undergo the interlaminar technique and 24 patients the transforaminal technique. They were evaluated using visual analog scale and Oswestry disability index in the preoperative period, in the first postoperative period, and in the 12th month after the procedure. The clinical results between the two techniques were then compared.RESULTS: Overall, 89.1% of the patients obtained good results, with 12.5% complications in the transforaminal technique and 9.6% in the interlaminar technique.CONCLUSION: Although both the endoscopic techniques, compared in this study, are safe and effective for the surgical treatment of lumbar herniated disc, the interlaminar technique presented significantly better results and lower rates of complications than the transforaminal technique.
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