Acute medullar compression secondary to a septic arthritis of a thoracic facet joint: a case report and review of literature

Huguet, Sandra; Ibañez, Natalia; Bernaus, Martí; Font-Vizcarra, Lluís

doi:10.1038/s41394-018-0117-0

Cited by 3 publications

(1 citation statement)

References 16 publications

(90 reference statements)

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“…Of the 3 patients with full neurologic recovery, 2 were treated with decompressive laminectomy and antibiotics, and the other was treated with antibiotics alone. Of the 5 patients with partial neurologic recovery, 4 were treated with decompressive laminectomy and antibiotics, and 1 received antibiotics alone [ 31 , 44 , 46 , 52 , 56 ]. The patient with persistent paraplegia received antibiotics alone [ 29 ], and the patient who died of septic shock received antibiotics and underwent decompressive laminectomy [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

Septic Arthritis of the Spinal Facet Joint: Review of 117 Cases

Ross,

Ard

2024

Open Forum Infectious Diseases

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Background Septic arthritis of the spinal facet joints is increasingly recognized in the era of magnetic resonance imaging, but its epidemiology, clinical features, management, and prognosis are ill-defined. Methods We review 101 previously published cases, and report 16 cases occurring at our institutions between 2006 and 2018. Results Most patients presented with fever (60%) and back or neck pain (86%). Radiation into the hip, buttock, or limb was present in 34%. The lumbosacral vertebral segments were involved in 78% of cases. Most cases (64%) were due to Staphylococcus aureus. Bacteremia was present in 66%, and paraspinal muscle abscesses in 54%. While epidural abscesses were present in 56%, neurological complications were seen in only 9%, likely because most abscesses arose below the conus medullaris. Neurologic complications were more common with cervical or thoracic involvement than lumbosacral (32% vs 2%, p < 0.0001). Extraspinal infection, such as endocarditis, was identified in only 22% of cases. 98% of patients survived, with only 5% having neurologic sequelae. Conclusions Septic arthritis of the facet joint is a distinct clinical syndrome typically involving the lumbar spine, and frequently associated with bacteremia, posterior epidural abscesses, and paraspinal pyomyositis. Neurologic outcomes are usually good with medical management alone.

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