J Korean Orthop Assoc.  1966 Oct;1(1):49-57. 10.4055/jkoa.1966.1.1.49.

Clinical Observation of Hematogenous Pyogenic Osteomyelitis of the Spine: Report of Ten Cases

• Chung SM
• Kim KH
• Chung IH

• KMID: 2464898
• DOI: http://doi.org/10.4055/jkoa.1966.1.1.49

Abstract

Ten cases of hematogenous pyogenic osteomyelitis of the spine were seen in a total of 436 cases of osteomyelitis during the past thirteen years (from January 1952 to December 1964) at Yonsei University Hospital. 1) The incidence of total osteomyelitis cases was 2.29%. The incidence was maximum in the the twenty to thirty age group. The sex ratio was 2.3: 1. (Male: Female) 2) The offending organism was the coagulase positive staphylococcus in all cases. 3) The site of infection was in the lumbar vertebrae in seven cases, thoracic in two and cervical in one. 4) The predisposing factors were unknown in five cases and one case each of trauma, multiple abscess, urinary tract infection, peritonitis and chronic otitis media. 5) The clinical symptoms and signs consisted of acute onset of fever with chill (9 cases), severe back pain (all cases), limitation of spinal motion (all cases), spasm of spinal erector muscles (3 cases), nerve root irritation (3 cases), difficult urination (none), scoliosis (1 case), tenderness over the involved spinous process (all cases), some neurological signs of numbness, weakness or paraplegia (2 cases). 6) The main complications were a draining sinus (4 cases) or abscess formation (4 cases), pyogenic meningitis (none) and paraplegia (2 cases). 7) The roentgenographic findings showed a narrowing of intervertebral disc spaces (9 cases), moth-eaten irregularity of the involved vertebral margins (5 cases), increased density with some areas of mottled rarefaction of the involved vertebrae (5 cases), bone spur or bridge formation between the involved vertebrae (3 cases), scoliosis (1 case) and paravertebral abscess formation (4 cases). 8) The laboratory findings showed an elevation of blood sedimentation rate and some leukocytosis. 9) All cases were treated with surgery followed by antibiotics and rest. The three cases received anterior spinal interbody fusion with an autogenous bone graft through an anterior approach. 10) In spite of a current trend for the conservative treatment, we performed operations because of the complications of draining sinus (4 cases) or abscess formation (4 cases) and paraplegia (2 cases). 11) The immediate results (postoperative 6 months) were satisfactory in all cases.

MeSH Terms

Abscess
Anti-Bacterial Agents
Back Pain
Blood Sedimentation
Causality
Coagulase
Fever
Humans
Hypesthesia
Incidence
Intervertebral Disc
Leukocytosis
Lumbar Vertebrae
Meningitis
Multiple Trauma
Muscles
Osteomyelitis*
Osteophyte
Otitis Media
Paraplegia
Peritonitis
Scoliosis
Sex Ratio
Spasm
Spine*
Staphylococcus
Transplants
Urinary Tract Infections
Urination
Anti-Bacterial Agents
Coagulase