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    Diagnosis and management of spinal cord emergencies.
    Handb Clin Neurol 2017 ;140:319-335
    Department of Neurology, Mayo Clinic, Rochester, MN, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA. Electronic address:
    Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. Read More

    Evaluating Complications of Chronic Sinusitis.
    Case Rep Emerg Med 2017 9;2017:8743828. Epub 2017 Jan 9.
    Department of Emergency Medicine, New York Methodist Hospital, Brooklyn, NY, USA.
    Chronic sinusitis is a relatively common diagnosis throughout the US. In patients with an otherwise unremarkable medical history the treatment is typically supportive, requiring only clinical evaluation. We present the case of a 25-year-old male with a history of chronic sinusitis that was brought to our emergency department with new-onset seizure. Read More

    Lateral lumbar retroperitoneal transpsoas approach in the setting of spondylodiscitis: A technical note.
    J Clin Neurosci 2017 Jan 31. Epub 2017 Jan 31.
    Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, United States. Electronic address:
    Thoracolumbar spondylodiscitis is a morbid disease entity, impacting a sick patient population with multiple comorbidities. Wherever possible, surgical measures in this population should limit the extent of soft tissue disruption and overall morbidity that is often associated with anteroposterior thoracolumbar decompression and fusion. The authors describe the rationale, technique, and use of the lateral lumbar transpsoas retroperitoneal approach in tandem with posterior decompression and instrumented fusion in the treatment of circumferential thoracolumbar spondylodiscitis with or without epidural abscesses. Read More

    Neuraxial Anesthesia and the Use of Sterile Gowning.
    AORN J 2017 Feb;105(2):184-192
    Epidural or spinal anesthesia-related infections cause serious and devastating morbidity and mortality. The possible infectious complications of neuraxial anesthesia have become better understood in the past 10 years. We assessed information from published case series, studies, randomized controlled trials, and retrospective cohort studies to determine the rate of neuraxial infection and to evaluate iatrogenic causes of infection. Read More

    Prognostic Factors for Failure of Antibiotic Treatment in Patients With Osteomyelitis of the Spine.
    Spine (Phila Pa 1976) 2017 Jan 27. Epub 2017 Jan 27.
    *Department of Orthopaedic Surgery, Spine Surgery Service, Massachusetts General Hospital - Harvard Medical School †Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital - Harvard Medical School ‡Department of Infectious Diseases, Massachusetts General Hospital - Harvard Medical School §Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Spine Surgery Service, Massachusetts General Hospital - Harvard Medical School.
    Study Design: Retrospective cohort study.

    Objective: Identify factors independently associated with antibiotic treatment failure in patients with spinal osteomyelitis.

    Summary Of Background Data: There are few studies that have identified risk factors for antibiotic treatment failure in medically-managed spinal osteomyelitis. Read More

    Primary spinal epidural B-lymphoblastic lymphoma.
    Proc (Bayl Univ Med Cent) 2017 Jan;30(1):66-68
    Department of Medical Oncology, Regional Cancer Centre, Trivandrum, India.
    Extranodal lymphomas constitute 20% to 30% of all non-Hodgkin's lymphomas. The common sites involved are skin, stomach, brain, and small intestine. Epidural localization is a rare site for lymphomas, accounting for 10% of spinal epidural tumors. Read More

    A Rare Case of Disseminated Pyogenic Gonococcal Infection in an Immunocompetent Woman.
    Case Rep Infect Dis 2016 27;2016:9629761. Epub 2016 Dec 27.
    Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece.
    We present a case of previously healthy, immunocompetent, 41-year-old woman who developed systemic inflammatory response syndrome secondary to Neisseria gonorrhoeae bacteremia. Clinical course was complicated by the simultaneous formation of multiple muscular abscesses, epidural abscess, and septic spondylodiscitis. The patient responded well to prolonged ceftriaxone treatment and was released 10 weeks after initial admission. Read More

    Serratus anterior plane block for hybrid transthoracic esophagectomy: a pilot study.
    J Pain Res 2017 4;10:73-77. Epub 2017 Jan 4.
    Department of General Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, Milano, Italy.
    Background: Pain is a major limiting factor in patient's recovery from major thoracic surgical procedures. Thoracic epidural analgesia (TEA), the current gold standard of perioperative management, has contraindications, can technically fail, and carries a risk of complications such as epidural abscess and spinal hematoma. The ultrasound-guided serratus anterior plane (SAP) block is a promising regional analgesia technique. Read More

    Percutaneous epidural drainage through a burr hole.
    Indian J Radiol Imaging 2016 Oct-Dec;26(4):469-471
    Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil.
    Intracranial extradural collection may cause an increase in intracranial pressure, requiring rapid emergency treatment to reduce morbidity and mortality. We described an alternative CT-guided percutaneous access for extradural collection drainage. We report a case of a patient with previous craniectomy for meningioma ressection who presented to the Emergency Department with symptoms of intracranial hypertension. Read More

    Magnetic resonance imaging findings of patients with suspected tuberculosis from a tertiary care centre in Sri Lanka
    Ceylon Med J 2016 12;61(4):185-188
    Magnetic Resonance Imaging, Neurosurgical Unit, National Hospital of Sri Lanka, Sri Lanka.
    Introduction: Spinal tuberculosis (TB) is a relatively common cause for spinal pathology in Sri Lanka and a common indication for magnetic resonance imaging (MRI).

    Objectives: The objective of the study was to describe the MRI imaging pattern of spinal TB in a series of patients.

    Methods: One hundred and nine patients with clinically confirmed spinal tuberculosis who had undergone MRI scans at the National Hospital of Sri Lanka from 2012-2016 were included in the study. Read More

    Quadriplegia caused by an epidural abscess occurring at the same level of cervical destructive spondyloarthropathy: a case report.
    BMC Musculoskelet Disord 2017 Jan 10;18(1):11. Epub 2017 Jan 10.
    Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, College of Medicine, the Catholic University of Korea, 62 Yeouido-dong, Youngdeungpo-ku, Seoul, 150-010, Republic of Korea.
    Background: Destructive spondyloarthropathy (DSA) is one of the major complications in patients undergoing long-term hemodialysis. To the best of our knowledge, an epidural abscess occurring at the level of preexisting cervical DSA has not been well described in the literature. We report a unique case of quadriplegia caused by an epidural abscess occurring at the same level of preexisting cervical DSA. Read More

    Cervical Spondylitis and Epidural Abscess Caused by Brucellosis: a Case Report and Literature Review.
    Folia Med (Plovdiv) 2016 Dec;58(4):289-292
    Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae. Read More

    Thermal-Induced Osteonecrosis of Adjacent Vertebra after Intradiscal Electrothermal Therapy.
    J Korean Neurosurg Soc 2017 Jan 29;60(1):114-117. Epub 2016 Dec 29.
    Department of Neurosurgery, Spine Center, Samsung Medical Center Sungkyunkwan University, School of Medicine, Seoul, Korea.
    A 42-year-old man was admitted to our hospital with complaints of low back pain and intermittent right thigh pain. Twelve weeks before admission, the patient received intradiscal electrothermal therapy (IDET) at a local hospital. The patient still reported low back pain after the procedure that was managed with narcotic analgesics. Read More

    Long term outcome of medical and surgical co-management of craniospinal aspergillosis in an immunocompromised patient.
    Med Mycol Case Rep 2016 Dec 29;14:33-37. Epub 2016 Nov 29.
    Department of General Medicine, Amrita Institute of Medical Sciences and Research Centre, Ponekkara, Kochi 682041, India.
    35 yr old steroid dependent lady with Pulmonary TB underwent debridement of epidural abscess & posterior stabilization for paraparesis. With histopathology and cultures showing Aspergillus fumigatus, voricanozole was started. By the fourth week, she developed persistent fever, and altered mental status. Read More

    Brucellar spondylodiscitis with rapidly progressive spinal epidural abscess showing cauda equina syndrome.
    Spinal Cord Ser Cases 2016 7;2:15030. Epub 2016 Jan 7.
    Department of Orthopaedics Surgery, Air Force General Hospital of PLA, The Air Force General Hospital of Dalian Medical University , Beijing, China.
    Early diagnosis of Brucellosis is often difficult in the patient with only single non-specific symptom because of its rarity. We report a patient with Brucellar spondylodiscitis, in which the low back pain was the only symptom and the magnetic resonance imaging (MRI) showed not radiographic features about infection at initial stage. He was misdiagnosed as a lumbar disc herniation for inappropriate treatment in a long time. Read More

    Spinal Epidural Abscess: A Review with Special Emphasis on Earlier Diagnosis.
    Biomed Res Int 2016 1;2016:1614328. Epub 2016 Dec 1.
    Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
    Spinal epidural abscess (SEA) is an uncommon but serious condition with significant morbidity and mortality. The prognosis of SEA is highly dependent on the timeliness of its diagnosis before neurological deficits develop. Unfortunately, often due to its nonspecific presentation, such as back pain, the diagnosis of SEA may be delayed in up to 75% of cases. Read More

    [Epidural abscess secondary to sinusitis].
    Ugeskr Laeger 2016 Dec;178(52)
    Approximately 0.5-2% of upper viral infections are com-licated by secondary acute bacterial sinusitis and may in rare cases evolve into more serious complications such as meningitis and intracranial abscess. Symptoms are often subtle and nonspecific as fever, headache, scalp tenderness, nausea and altered mental status. Read More

    Combination Therapy With Vancomycin and Ceftaroline for Refractory Methicillin-resistant Staphylococcus aureus Bacteremia: A Case Series.
    Clin Ther 2017 Jan 27;39(1):212-218. Epub 2016 Dec 27.
    Department of Pharmacy, Mount Sinai Beth Israel, New York, New York.
    Purpose: Although vancomycin has been the mainstay of therapy for methicillin-resistant Staphylococcus aureus (MRSA) infections, its effectiveness has been challenged. Combination therapy may be used for patients with persistent MRSA bacteremia refractory to initial therapy. Studies have reported in vitro synergy between vancomycin and ceftaroline; however, clinical experience with this therapy is limited. Read More

    Spinal epidural abscess in a patient with piriformis pyomyositis.
    Surg Neurol Int 2016 21;7(Suppl 38):S911-S913. Epub 2016 Nov 21.
    Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
    Background: Spinal epidural abscess resulting from piriformis pyomyositis is extremely rare. Such condition can result in serious morbidity and mortality if not addressed in a timely manner.

    Case Description: The authors describe the case of a 19-year-old male presenting with a 2-week history of fever, low back pain, and nuchal rigidity. Read More

    [Acute mastoiditis with retroauricular abscess - a report of two cases].
    Pol Merkur Lekarski 2016 Dec;41(246):293-295
    Department of Laryngology, Regional Centre of Health in Kluczbork, Poland.
    : Otogenic complications may occur as a result of both acute and chronic otitis media. The purpose of the diagnostic process and treatment of patients with otogenic complications is to identify and eliminate focal points of the infection. Due to general application of antibiotics, these complications are rarely observed. Read More

    Spinal Epidural Abscess in Adults: A 10-Year Clinical Experience at a Tertiary Care Academic Medical Center.
    Open Forum Infect Dis 2016 Oct 14;3(4):ofw191. Epub 2016 Sep 14.
    Academic Affairs, Baystate Health , Springfield, Massachusetts.
    Background.  Delayed recognition of spinal epidural abscess (SEA) contributes to poor outcomes from this highly morbid and potentially lethal infection. We performed a case-control study in a regional, high-volume, tertiary care, academic medical center over the years 2005-2015 to assess the potential changing epidemiology, clinical and laboratory manifestations, and course of this disorder and to identify factors that might lead to early identification of SEA. Read More

    Septic Arthritis of an Atlantoaxial Facet Joint with Normal Inflammatory Markers: Case Report and Literature Review.
    World Neurosurg 2016 Dec 18. Epub 2016 Dec 18.
    Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
    Background: Septic arthritis of the atlantoaxial facet joint is extremely rare. Contiguous spread to the median atlantoaxial joints with subsequent dens erosion can lead to atlantoaxial instability. Misleading normal inflammatory markers can result in delayed diagnosis and catastrophic consequences. Read More

    Neurological deficit secondary to a pre-sacral abscess with epidural extension up to L3: A case report and literature review.
    Orthop Traumatol Surg Res 2017 Feb 12;103(1):133-135. Epub 2016 Dec 12.
    Orthopedics Department, Georges Pompidou European Hospital, 75015 Paris, France; Paris-Descartes University, 75006 Paris, France.
    Isolated epidural abscesses are uncommon lesions. Surgical treatment may be difficult due to the extension of these lesions. We present a case of a pelvic abscess spreading along the path of the sciatic nerve to the gluteus muscles and the lumbar canal, causing neurological compression; requiring surgical treatment with three simultaneous approaches. Read More

    Rare cause of back pain: Staphylococcus aureus vertebral osteomyelitis complicated by recurrent epidural abscess and severe sepsis.
    BMJ Case Rep 2016 Dec 13;2016. Epub 2016 Dec 13.
    Department of Trauma and Orthopaedic Surgery, Royal Berkshire NHS Foundation Trust, Reading, UK.
    An epidural abscess represents a rare acute medical emergency, with a reported incidence of 2.5/10 000 hospital admissions annually. The clinical features include fever, spinal pain, radiating nerve root pain and leg weakness. Read More

    First report on treating spontaneous infectious spondylodiscitis of lumbar spine with posterior debridement, posterior instrumentation and an injectable calcium sulfate/hydroxyapatite composite eluting gentamicin: a case report.
    J Med Case Rep 2016 Dec 12;10(1):349. Epub 2016 Dec 12.
    Department of Trauma and Hand Surgery, University Hospital of Düsseldorf, Düsseldorf, 40225, Germany.
    Background: Spontaneous infectious spondylodiscitis is a rare, but serious disease with the risk of progressive neurological impairment. The surgical approach to spontaneous infectious spondylodiscitis is in most cases an anterior debridement and fusion, often in staged surgeries. Here we report a case of single-stage posterior debridement and posterior instrumented fusion in combination with an injectable calcium sulfate/hydroxyapatite composite eluting gentamicin. Read More

    Thoracic spinal epidural abscess caused by fishbone perforation: A case report and review of literature.
    Medicine (Baltimore) 2016 Dec;95(49):e5283
    Department of Rehabilitation Medicine, First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
    Rationale: Ingestion of a fishbone is a common cause of esophageal injury, but spinal epidural abscess (SEA) is a rare condition due to the esophageal penetration by a swallowed fishbone. Prompt diagnosis can be seldom made owing to incomplete patient history taking and difficulties in imaging evidence identification.

    Patient Concerns: We describe the case of a 62-year-old woman who was stuck in her throat by a fishbone, and complained of back pain, paresis of the lower limbs and fever, successively. Read More

    Comparison of gram-negative and gram-positive hematogenous pyogenic spondylodiscitis: clinical characteristics and outcomes of treatment.
    BMC Infect Dis 2016 Dec 6;16(1):735. Epub 2016 Dec 6.
    Department of Orthopedic Surgery, Chang Gung Memorial Hospital, No. 6, West Sec., Chia Pu Rd., PuTz, Chiayi, Taiwan.
    Background: To the best of our knowledge, no study has compared gram-negative bacillary hematogenous pyogenic spondylodiscitis (GNB-HPS) with gram-positive coccal hematogenous pyogenic spondylodiscitis (GPC-HPS) regarding their clinical characteristics and outcomes.

    Methods: From January 2003 to January 2013, 54 patients who underwent combined antibiotic and surgical therapy in the treatment of hematogenous pyogenic spondylodiscitis were included.

    Results: Compared with 37 GPC-HPS patients, the 17 GNB-HPS patients were more often found to be older individuals, a history of cancer, and a previous history of symptomatic urinary tract infection. Read More

    Clinical case report: discitis osteomyelitis complicated by inferior vena cava venous thrombosis and septic pulmonary emboli.
    Radiol Case Rep 2016 Dec 17;11(4):370-374. Epub 2016 Sep 17.
    Department of Radiology, Einstein Medical Center, 5501 Old York Road, Philadelphia, PA 19141, USA.
    Viridans group streptococcus is an infrequent cause of osteomyelitis that is found in association with infective endocarditis. Only a few studies report viridans osteomyelitis in the absence of endocarditis. Vertebral pyogenic osteomyelitis can sometimes be complicated by psoas or paraspinal abscesses. Read More

    Intrathecal Baclofen Therapy for the Treatment of Spasticity in Lithuania.
    J Neurol Surg A Cent Eur Neurosurg 2016 Nov 30. Epub 2016 Nov 30.
    Centre of Rehabilitation and Physical Medicine, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
    Spasticity of cerebral or spinal origin severely impairs an individual's functional ability and quality of life. Intrathecal baclofen (ITB) therapy via an implantable pump is indicated for use in patients unresponsive to oral antispasmodics. ITB therapy improves the daily caring for and relief of painful spasms. Read More

    Multidisciplinary Approach to an Extended Pressure Sore at the Lumbosacral Area.
    Arch Plast Surg 2016 Nov 18;43(6):586-589. Epub 2016 Nov 18.
    Dr. Hudson Lázaro, Cirurgia Plástica Transplante Capilar, Pará de Minas, Brazil.
    A pressure sore wound is often extensive or complicated by local infection involving adjacent soft tissue and bone. In this case, a regional flap after simple debridement is not adequate. Here, we present a case of an extensive pressure sore in the sacral area with deep tissue infection. Read More

    Imaging in spinal posterior epidural space lesions: A pictorial essay.
    Indian J Radiol Imaging 2016 Jul-Sep;26(3):299-315
    Department of Radiology, TNMC and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India.
    Spinal epidural space is a real anatomic space located outside the dura mater and within the spinal canal extending from foramen magnum to sacrum. Important contents of this space are epidural fat, spinal nerves, epidural veins and arteries. Due to close proximity of posterior epidural space to spinal cord and spinal nerves, the lesions present with symptoms of radiculopathy and/or myelopathy. Read More

    Comparing outcomes of early, late, and non-surgical management of intraspinal abscess.
    J Clin Neurosci 2017 Feb 9;36:64-71. Epub 2016 Nov 9.
    Department of Neurosurgery, Duke University Medical Center, Durham, NC 27710, United States. Electronic address:
    Intraspinal abscesses (ISAs) are rare lesions that are often neurologically devastating. Current treatment paradigms vary widely including early surgical decompression, drainage, and systemic antibiotics, delayed surgery, and sole medical management. The National Inpatient Sample (NIS) database was queried for cases of ISA from 2003 to 2012. Read More

    Effect of thoracic epidural block on infection-induced inflammatory response: A randomized controlled trial.
    J Crit Care 2016 Oct 18;38:6-12. Epub 2016 Oct 18.
    Department of Anaesthesiology & Critical Care, University College of Medical Sciences & GTB Hospital, Delhi 110095, India. Electronic address:
    Purpose: Epidural block decreases inflammation and oxidative stress in experimental models of sepsis as well as after surgery. There is, however, no clinical evidence evaluating its effect on infection-induced inflammatory process. The present trial evaluated the effect of thoracic epidural block (TEB) on systemic inflammatory response in patients with small intestinal perforation peritonitis. Read More

    Spinal epidural abscess: a rare complication of ulcerative colitis after ileal pouch anal anastomosis.
    Surg Case Rep 2016 Dec 7;2(1):128. Epub 2016 Nov 7.
    Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
    Background: Spinal epidural abscess is a rare condition with high morbidity and mortality, for which a delay in diagnosis and treatment can lead to irreversible neurologic deficit or even death. Although patients with spinal epidural abscess have systemic predisposing immunocompromised conditions, spinal intervention, or trauma, this condition has been reported as a result of perforation or fistulization arising from inflammatory bowel disease. We describe herein a rare case of spinal epidural abscess as a complication of ileal pouch anal anastomosis. Read More

    When Do You Drain Epidural Abscesses of the Spine?
    Surg Technol Int 2016 Oct;XXIX:374-378
    Department of Orthopaedic Surgery, Seton Hall University, St Joseph's Regional Medical Center, Paterson, NJ.
    Background: How the relative volume of an epidural abscess on MRI affects outcomes with antibiotics alone has limited literature. The purpose of this study was to identify which infected epidural collections will reabsorb with antibiotics alone. Specifically, what is the critical size and enhancement on contrast MRIs to require a drainage procedure?

    Materials And Methods: A retrospective review of all spinal osteomyelitis patients from 2001-2012 was performed. Read More

    Management of acute complicated mastoiditis at an urban, tertiary care pediatric hospital.
    Laryngoscope 2016 Oct 31. Epub 2016 Oct 31.
    Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
    Objectives/hypothesis: To describe the presentation and management of acute complicated mastoiditis in children.

    Study Design: Retrospective case series.

    Methods: An analysis of pediatric patients with acute complicated mastoiditis treated at an urban, tertiary care children's hospital from 2007 to 2014 was performed. Read More

    Oblique corpectomy for treatment of cervical spine epidural abscesses: Report on four cases.
    Neurol Neurochir Pol 2016 Nov - Dec;50(6):491-496. Epub 2016 Aug 24.
    Medical University of Warsaw, Poland.
    Background: Spinal epidural abscesses (SEAs) in cervical locations are particularly life-threatening. Currently, SEAs are widely treated with bony decompression, followed by internal stabilization in purulent osteomyelitis. However, recently, a growing number of studies have reported minimally invasive approaches without internal fixation. Read More

    Spinal infections in older people: an analysis of demographics, presenting features, microbiology and outcomes.
    Intern Med J 2017 Feb;47(2):182-188
    Department of Infectious Diseases, Northern Health, Melbourne, Victoria, Australia.
    Background: Clinical features of infection can become more atypical as we age. Spinal infections can be insidious, and timely diagnosis and treatment are essential to prevent adverse outcomes.

    Aims: To explore differences in presentation and outcomes between younger and older patients with bacterial spinal infections. Read More

    Epidural abscess after epidural analgesia in children: report of two cases.
    Eur J Anaesthesiol 2016 Nov;33(11):866-867
    From the Children's Acute Pain Service (RD), Department of Anaesthesia, Children's Acute Pain Service (UD), Department of Neurosurgery (DR), Department of Anaesthesia, Children's Acute Pain Service, Birmingham Children's Hospital, Birmingham, UK (K-CT).

    Acute Nontraumatic Back Pain: Risk Stratification, Emergency Department Management, and Review of Serious Pathologies.
    Emerg Med Clin North Am 2016 Nov 3;34(4):743-757. Epub 2016 Sep 3.
    Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Place, Boston, MA 02115, USA. Electronic address:
    Acute back pain is a common presenting complaint in the emergency department that leads to a great deal of resource utilization. The differential diagnosis is long and most cases are caused by benign pathology that will resolve on its own. Imaging is over-used and rarely helps. Read More

    Comparison of characteristics of culture-negative pyogenic spondylitis and tuberculous spondylitis: a retrospective study.
    BMC Infect Dis 2016 Oct 12;16(1):560. Epub 2016 Oct 12.
    Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Republic of Korea.
    Background: Differences between the characteristics of culture positive pyogenic spondylitis (CPPS) and tuberculous spondylitis (TS) are well known. However, differences between the characteristics of culture negative pyogenic spondylitis (CNPS) and TS have not been reported; these would be more helpful in clinical practice especially when initial microbiologic examination of blood and/or biopsy tissue did not reveal the causative bacteria in patients with infectious spondylitis.

    Methods: We performed a retrospective review of the medical records of patients with CNPS and TS. Read More

    Epidural Hematoma and Abscess Related to Thoracic Epidural Analgesia: A Single-Center Study of 2,907 Patients Who Underwent Lung Surgery.
    J Cardiothorac Vasc Anesth 2016 Jul 18. Epub 2016 Jul 18.
    Department of Anesthesiology, Hôpital Foch, Suresnes, France; Université Versailles Saint-Quenti- en-Yvelines, Versailles, France.
    Objective: To report the major complications (epidural hematoma and abscess) of postoperative thoracic epidural analgesia in patients who underwent lung surgery.

    Design: Prospective, monocentric study.

    Setting: A university hospital. Read More

    Parascapular mass revealing primary tuberculosis of the posterior arch.
    Quant Imaging Med Surg 2016 Aug;6(4):454-456
    Department of Radiology, Section of Musculoskeletal Imaging and Intervention, François-Mitterrand Teaching Hospital, Dijon Cedex, France.
    We report the case of a parascapular abscess revealing primary tuberculosis of the posterior arch in a 31-year-old man. Sectional imaging is essential in order to detect the different lesions of this atypical spinal tuberculosis as osteolysis of the posterior arch extendible to vertebral body, osteocondensation, epidural extension which is common in this location, and high specificity of a zygapophysial, costo-vertebral or transverse arthritis. Read More

    Rapidly Progressive Spontaneous Spinal Epidural Abscess.
    Case Rep Infect Dis 2016 5;2016:7958291. Epub 2016 Sep 5.
    Neurosurgery Department, Yuzuncu Yıl University Faculty of Medicine, 65040 Van, Turkey.
    Spinal epidural abscess (SEA) is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. Read More

    Development of Epidural and Paraspinal Abscesses after Insufficient Evaluation and Treatment of Acute Pyelonephritis Caused by Staphylococcus aureus.
    Korean J Fam Med 2016 Sep 21;37(5):299-302. Epub 2016 Sep 21.
    Division of Nephrology, Department of Internal Medicine, Gimpo Woori Hospital, Gimpo, Korea.
    Diagnoses of pyelonephritis caused by Staphylococcus aureus should be accompanied by investigations of concomitant bladder obstruction and metastatic infections, especially to the spine or heart. Complicated pyelonephritis due to S. aureus requires more than 2 weeks of antibiotics, which is the typically recommended treatment duration for pyelonephritis. Read More

    Thoracic osteomyelitis and epidural abscess formation due to cat scratch disease: case report.
    J Neurosurg Pediatr 2016 Dec 23;25(6):713-716. Epub 2016 Sep 23.
    Departments of 1 Neurological Surgery and.
    Osteomyelitis of the spine with associated spinal epidural abscess represents an uncommon entity in the pediatric population, requiring prompt evaluation and diagnosis to prevent neurological compromise. Cat scratch disease, caused by the pathogen Bartonella henselae, encompasses a wide spectrum of clinical presentations; however, an association with osteomyelitis and epidural abscess has been reported in only 4 other instances in the literature. The authors report a rare case of multifocal thoracic osteomyelitis with an epidural abscess in a patient with a biopsy-proven pathogen of cat scratch disease. Read More

    Role of Percutaneous Image Guided Biopsy in Spinal Lesions: Adequacy and Correlation with MRI Findings.
    J Clin Diagn Res 2016 Aug 1;10(8):RC11-5. Epub 2016 Aug 1.
    Associate Professor, Department of Orthopedics, Kasturba Medical College, Mangalore, Manipal University , Karnataka, India .
    Introduction: Although, MRI has increased our understanding of spinal pathologies, accurate diagnosis of spinal lesions need biopsy, so that early treatment can be initiated.

    Aim: To evaluate the accuracy of biopsy, safety and yield of percutaneously done image guided spinal biopsy using a large bore needle and correlate between MRI findings and biopsy as well as the importance of various MRI findings in establishing the diagnosis.

    Materials And Methods: All spinal lesions after clinical and MRI evaluation were subjected to Jamshidi Needle biopsy using 11 gauge needles. Read More

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