Pyogenic spondylitis presenting with skip lesions

Po Liang Lai, Hsieh Shong Leu, Chi Chien Niu, Wen Jer Chen, Lih Huei Chen*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

4 Scopus citations

Abstract

We report on a 65-year-old man who presented with a 1-month history of aggravating backache and low-grade fever. He suddenly became paraplegic (Frankel B). Muscle power was grade 0-1 over the bilateral lower limbs. X-ray films showed disc space narrowing and end-plate blurring at the T9-T11 and L4-L5 levels. Magnetic resonance imaging showed an infectious lesion at T9-T11 and another at L4-L5. An emergent operation was performed under the impression of pyogenic spondylitis with spinal cord compression. The patient showed a significant recovery (Frankel D) after the thoracic and lumbar spinal surgeries. Pyogenic spondylitis usually presents as a vertebra-disc-vertebra lesion spreads to the contiguous vertebra-disc-vertebra unit. The current patient had pyogenic spondylitis with coexistent thoracic and lumbar lesions. This kind of skip lesion is common in spinal malignant metastasis, but rare in spinal infections. Awareness of the possibility of multiple lesions or skip lesions will facilitate the diagnosis and treatment of this condition.

Original languageEnglish
Pages (from-to)651-656
Number of pages6
JournalChang Gung Medical Journal
Volume28
Issue number9
StatePublished - 09 2005
Externally publishedYes

Keywords

  • Pyogenic spondylitis
  • Skip lesions
  • Vertebral osteomyelitis

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