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    1 OF 54
    Rogue one: a story of tophaceous gout in the spine.
    BMJ Case Rep 2018 Apr 17;2018. Epub 2018 Apr 17.
    Department of Anesthesia and Critical Care, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
    A 26-year-old man with history of extensive tophaceous gout presented to the referring facility with decreased bilateral lower extremity sensation and motor function that began acutely 1 week prior to admission and had progressed to urinary incontinence. The patient was admitted to the intensive care unit due to concern for sepsis secondary to epidural abscess. The patient was started on empiric vancomycin and cefepime. Read More
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    Spondylodiscitis following endovascular abdominal aortic aneurysm repair: imaging perspectives from a single centre's experience.
    Skeletal Radiol 2018 Apr 14. Epub 2018 Apr 14.
    Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, 2nd Floor Tower Wing, Great Maze Pond, London, SE1 9RT, UK.
    Objective: Very few reports have previously described spondylodiscitis as a potential complication of endovascular aortic aneurysm repair (EVAR). We present to our knowledge the first case series of spondylodiscitis following EVAR based on our institution's experience over an 11-year period. Particular attention is paid to the key imaging features and challenges encountered when performing spinal imaging in this complex patient group. Read More
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    Independent predictors of spinal epidural abscess recurrence.
    Spine J 2018 Apr 9. Epub 2018 Apr 9.
    Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA. Electronic address:
    Background Context: Recurrence of spinal epidural abscess (SEA) after treatment is an important cause of continued morbidity for patients.

    Purpose: The purpose of this study is to identify independent predictors of recurrence of SEA.

    Study Design/setting: This was a retrospective, case-control study. Read More
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    Lumbar Gout Tophus Mimicking Epidural Abscess with Magnetic Resonance Imaging, Bone, and Gallium Scans.
    Indian J Nucl Med 2018 Apr-Jun;33(2):158-160
    Department of Nuclear Medicine, University Hospital Infanta Cristina, Badajoz, Spain.
    Gout is a common metabolic disorder, typically diagnosed in peripheral joints. Tophaceous deposits in lumbar spine are a very rare condition with very few cases reported in literature. The following is a case report of a 52-year-old patient with low back pain, left leg pain, and numbness. Read More
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    Bone and joint infection.
    Clin Med (Lond) 2018 Mar;18(2):150-154
    Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
    Bone and joint infections include septic arthritis, prosthetic joint infections, osteomyelitis, spinal infections (discitis, vertebral osteomyelitis and epidural abscess) and diabetic foot osteomyelitis. All of these may present through the acute medical take. This article discusses the pathogenesis of infection and highlights the importance of taking a careful history and fully examining the patient. Read More
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    Nonoperative Management of Spinal Epidural Abscess: Development of a Predictive Algorithm for Failure.
    J Bone Joint Surg Am 2018 Apr;100(7):546-555
    Department of Orthopaedic Surgery (A.A.S., P.T.O., M.B.H., and J.H.S.) and Division of Infectious Diseases (S.B.N.), Massachusetts General Hospital, Boston, Massachusetts.
    Background: Prompt diagnosis and treatment are critical in spinal epidural abscess, as delay can lead to paralysis or death. The initial management decision for spinal epidural abscess is not always clear, with the literature showing conflicting results. When considering nonoperative management, it is crucial to avoid failure of treatment, given the neurologic compromise incurred through failure. Read More
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    Postoperative Infection in Patients Undergoing Posterior Lumbosacral Spinal Surgery: A Pictorial Guide for Diagnosis and Early Treatment.
    Clin Spine Surg 2018 Mar 27. Epub 2018 Mar 27.
    Department of Medical Imaging and Intervention, Chang-Gung Memorial Hospital at Linkou and Chang-Gung University, Taoyuan, Taiwan.
    Surgical site infections after posterior spinal surgery may lead to spondylodiscitis, pseudarthrosis, correction loss, adverse neurological sequelae, sepsis, and poor outcomes if not treated immediately. Infection rates vary depending on the type and extent of operative procedures, use of instrumentation, and patients' risk factors. Image evaluation is crucial for early diagnosis and should be complementary to clinical routes, laboratory survey, and treatment timing. Read More
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    Acute prevertebral abscess secondary to intradiscal oxygen-ozone chemonucleolysis for treatment of a cervical disc herniation.
    J Int Med Res 2018 Jan 1:300060518764186. Epub 2018 Jan 1.
    1 Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.
    Objective We herein present a case involving a prevertebral abscess complicated by a spinal epidural abscess (SEA) secondary to intradiscal oxygen-ozone chemonucleolysis for treatment of a cervical disc herniation. Methods A 67-year-old woman with a history of intradiscal oxygen-ozone chemonucleolysis developed numbness and weakness in her right upper and bilateral lower extremities followed by urinary retention. Her symptoms did not respond to intravenous antibiotics alone. Read More
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    Recurrent discitis in the acute rehab setting: a case report.
    Spinal Cord Ser Cases 2018 21;4:23. Epub 2018 Mar 21.
    1Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, USA.
    Introduction: Discitis is an infection of the intervertebral disc space that can lead to paralysis, sepsis, epidural abscess, or other life-threatening complications if left untreated and may sometimes present with limited laboratory abnormalities to clue a diagnosis.

    Case Presentation: We present a case of a 67-year-old female in an acute rehabilitation setting who had presenting symptoms of sudden unexplained back pain refractory to pain control. She had a previous history of discitis and multiple failed knee replacement surgeries secondary to MSSA infections. Read More
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    Haematoma and abscess after neuraxial anaesthesia: a review of 647 cases.
    Br J Anaesth 2018 Apr 15;120(4):693-704. Epub 2018 Feb 15.
    Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
    Although rare, spinal haematoma and abscess after central neuraxial blocks may cause severe permanent neurological injury. Optimal treatment and outcome remain unclear. In order to identify possible predisposing patient characteristics and describe the ensuing clinical course, we searched Medline, Embase, and the Cochrane Library for reports of spinal haematomas and abscesses associated with central neuraxial blocks. Read More
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    Epidural analgesia is infrequently used in patients with acute pancreatitis : a retrospective cohort study.
    Acta Gastroenterol Belg 2017 Jul-Sep;80(3):381-384
    Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, Saitama Medical Center, Saitama, 330-0834, Japan.
    Backgrounds And Aims: Epidural analgesia is an option for pain control in patients with acute pancreatitis. The aim of this study is to describe characteristics, morbidity and mortality of patients with acute pancreatitis treated with epidural analgesia.

    Patients And Methods: Data was extracted from a national inpatient database in Japan on patients hospitalized with acute pancreatitis between July 2010 and March 2013. Read More
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    A Predictive Model Facilitates Early Recognition of Spinal Epidural Abscess in Adults.
    West J Emerg Med 2018 Mar 12;19(2):276-281. Epub 2018 Feb 12.
    University of Massachusetts Medical School-Baystate, Springfield, Massachusetts.
    Introduction: Spinal epidural abscess (SEA), a highly morbid and potentially lethal deep tissue infection of the central nervous system has more than tripled in incidence over the past decade. Early recognition at the point of initial clinical presentation may prevent irreversible neurologic injury or other serious, adverse outcomes. To facilitate early recognition of SEA, we developed a predictive scoring model. Read More
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    The Role of the Visor Flap in Scalp Reconstruction: A Case Series of 21 Patients.
    Oper Neurosurg (Hagerstown) 2018 Mar 14. Epub 2018 Mar 14.
    University of Illinois at Chicago, Chicago, Illinois.
    Background: Full-thickness scalp defects pose a reconstructive problem, especially in the setting of infection, chemotherapy/radiation, and underlying cranial defects. Current options include dermal matrices, skin grafts, and local flaps. Local flaps often fail, requiring subsequent microvascular free flap reconstruction. Read More
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    Causes of pneumocephalus and when to be concerned about it.
    Emerg Radiol 2018 Mar 15. Epub 2018 Mar 15.
    Department of Radiology, Division of Emergency Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY, 10467, USA.
    Intracranial gas is commonly detected on neuroimaging. The recognition of this finding can at first blush be unsettling. Being able to localize this gas to a specific compartment: intraarterial, intravenous, intraparenchymal, subdural, epidural, subarachnoid and intraventricular, is the first step in determining the importance of the gas. Read More
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    Simultaneous treatment of intracranial complications of paranasal sinusitis.
    Eur Arch Otorhinolaryngol 2018 May 13;275(5):1165-1173. Epub 2018 Mar 13.
    Department of Otolaryngology and Laryngological Oncology, University of Medical Sciences, Przybyszewskiego Street 49, 60-355, Poznań, Poland.
    Purpose: The objective of this study was to analyse 51 patients with intracranial complications of sinusitis treated in the Department of Otolaryngology and Laryngeal Oncology at Poznań University of Medical Sciences from 1964 to 2016.

    Materials And Methods: Males made up a significant portion of study participants at 70.5%. Read More
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    Lumbar spine epidural abscess and facet joint septic arthritis due to Streptococcus agalactiae: a case report.
    BMC Surg 2018 Mar 13;18(1):16. Epub 2018 Mar 13.
    Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
    Background: Here we report a rare case of lumbar spine epidural abscess and facet joint septic arthritis caused by Streptococcus agalactiae, which had spread to the iliopsoas muscles, leading to urine retention.

    Case Presentation: A 68-year-old woman with low back pain experienced a sudden onset of bilateral lower limb weakness, it was followed 14 days later by urine retention. At consultation, magnetic resonance imaging and identification of serum β-hemolytic streptococci provided a diagnosis of Streptococcus agalactiae infection. Read More
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    Aspergillus spinal epidural abscess: case presentation and review of the literature.
    Spinal Cord Ser Cases 2018 7;4:19. Epub 2018 Mar 7.
    1Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA USA.
    Study Design: In this review, we present a case of spinal epidural abscess (ASEA) and review the literature.

    Objectives: To provide further insight on a rare condition.

    Setting: A description of a patient with ASEA in a 58-year-old woman that was successfully treated with conservative management is presented. Read More
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    Tuberculous lumbar spinal epidural abscess in a young adult (case report).
    SICOT J 2018 9;4. Epub 2018 Mar 9.
    Medical City Complex, Baghdad, Iraq.
    Introduction: Spinal Epidural abscess (SEA) is an uncommon pathology that needs an urgent intervention to decompress the pressure on the spinal epidural sac, cord, and roots. The authors report a rare case of a young adult with lumbar spinal epidural tuberculous abscess occupying the spinal canal from L2-L5 vertebrae with extesion to the posterior paraspinal muscles and presenting with bilateral progressive lower limb weakness.   Case report: A 42 years old male teacher presented with a 15-day history of progressive difficulty to walking and bilateral lower limb weakness associated with fever, malaise and later on urinary incontinence. Read More
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    Epidural Abscess During a Spinal Cord Stimulator Trial: A Case Report.
    Pain Pract 2018 Mar 8. Epub 2018 Mar 8.
    Department of Anesthesiology and Pain Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
    Background: Spinal cord stimulation (SCS) can be beneficial for low back and radicular pain. A short trial of SCS evaluates the potential effectiveness of this therapy for a specific patient, while also decreasing the likelihood of a failed permanent implant. While rare, an epidural abscess is difficult to diagnose based on its nonspecific and unreliable clinical presentation. Read More
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    Clinical outcomes of percutaneous suction aspiration and drainage for the treatment of infective spondylodiscitis with paravertebral or epidural abscess.
    Spine J 2018 Feb 26. Epub 2018 Feb 26.
    Department of Orthopedic Surgery, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan.
    Background Context: Patients with infective spondylodiscitis who failed conservative treatment are generally indicated for open surgery. However, some patients are poor candidates for standard surgery, hence the need to evaluate less invasive approaches. Good outcomes were previously reported for percutaneous suction aspiration and drainage (PSAD) in the treatment of infective spondylodiscitis resistant to conservative therapy. Read More
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    Postoperative epidural abscess after spinal anaesthesia for a circumcision necessitated by phimosis.
    BMJ Case Rep 2018 Feb 23;2018. Epub 2018 Feb 23.
    Department of Surgery, Franciscus Vlietland, Schiedam.
    A 70-year-old man was admitted to our hospital for a penile circumcision due to phimosis using continuous dose spinal anaesthesia. On postoperative day 10 he came to the emergency department with a superficial abscess localised at the injection site of the spinal catheter. He was treated with intravenous antibiotics for 10 days, and the superficial abscess was incised and drained. Read More
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    A case series of continuous paravertebral block in minimally invasive cardiac surgery.
    JA Clin Rep 2017 29;3(1):45. Epub 2017 Aug 29.
    2Department of Anesthesia, Ohnishi Neurological Center, 1661-1 Eigashima Ookubo-cho, Akashi, Hyogo 674-0064 Japan.
    Background: Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. For this, good coverage analgesia is essential. Epidural anesthesia, a standard technique for thoracic surgery, has high risk of complications, such as epidural abscess and spinal hematoma in open-heart surgery. Read More
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    Imaging of Spondylodiscitis.
    Semin Nucl Med 2018 Mar 6;48(2):131-147. Epub 2018 Feb 6.
    Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
    Spondylodiscitis is an infection of the vertebral body or disc and may also involve the epidural space, posterior elements, and paraspinal soft tissues. It is a cause of morbidity and mortality, and warrants early diagnosis and prompt treatment. Diagnosis can be difficult because of nonspecific signs and symptoms. Read More
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    Spinal Cord Infarction Mimicking Acute Transverse Myelitis.
    Cureus 2017 Dec 6;9(12):e1911. Epub 2017 Dec 6.
    Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth.
    Spinal cord infarction (SCI) is a rare type of stroke. The initial magnetic resonance imaging (MRI) is usually normal and can mimic the presentation of the acute transverse myelitis (ATM), acute inflammatory demyelinating polyneuropathy, and compressive myelopathies from neoplasm, epidural or subdural hematoma, or abscess. The aim of this report is to describe and discuss the case of a patient with SCI presenting as a diagnostic confusion with acute transverse myelitis. Read More
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    Spinal cord compression secondary to epidural abscess: the importance of prompt diagnosis and management.
    BMJ Case Rep 2018 Feb 7;2018. Epub 2018 Feb 7.
    Acute Medicine, William Harvey Hospital, Ashford, UK.
    A 66-year-old woman presented with a 4-day history of fever, lethargy, neck and lower back pain. Neurological examination revealed mild quadraparesis. In view of this, MRI whole spine with contrast was performed and showed extensive spinal epidural abscess extending from the cervical to lumbar region causing compression of the thecal sac, spinal cord and nerves. Read More
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    Man-in-the-barrel syndrome: Case report of ventral epidural abscess and review of the literature.
    Surg Neurol Int 2018 16;9. Epub 2018 Jan 16.
    Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan, USA.
    Background: Man-in-the-barrel syndrome (MBS) is an uncommon clinical condition for which patients present with bilateral brachial diplegia but intact lower extremity strength. This syndrome is typically attributed to a cranial/cortical injury rather than a spinal pathology.

    Case Description: A 62-year-old diabetic male presented with bilateral upper extremity paresis attributed to a ventral cervical epidural abscess diagnosed on magnetic resonance imaging. Read More
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    Neurological Complications of Acute and Chronic Sinusitis.
    Curr Neurol Neurosci Rep 2018 Feb 5;18(2). Epub 2018 Feb 5.
    Loyola University Medical Center, Maywood, IL, USA.
    Purpose Of Review: Acute and chronic sinusitis can give rise to a wide array of intracranial and orbital complications. These complications include brain abscess, subdural empyema, epidural abscess, meningitis, venous sinus thrombosis, frontal bone osteomyelitis, and orbital cellulitis and abscess. Despite numerous medical advances, these complications carry a risk of mortality and significant morbidity. Read More
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    Tubercular spondylitis: A review of MRI findings in 80 cases.
    Med J Armed Forces India 2018 Jan 30;74(1):11-17. Epub 2016 Nov 30.
    Associate Professor, Department of Radiodiagnosis, Armed Forces Medical College, Pune 411040, India.
    Background: Tuberculosis of spine is known as tubercular spondylitis or Pott's spine. The vertebral involvement leads to various pathological processes such as abscess formation, cord compression, and gibbus deformity. Magnetic Resonance Imaging (MRI) is the imaging modality of choice which not only helps in diagnosing a case of Pott's spine but also gives valuable information about its impending complications, thereby, aiding in management of these cases. Read More
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    Management of spinal infection: a review of the literature.
    Acta Neurochir (Wien) 2018 Mar 22;160(3):487-496. Epub 2018 Jan 22.
    Department of Neurosurgery, Medical University lnnsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria.
    Spinal infection (SI) is defined as an infectious disease affecting the vertebral body, the intervertebral disc, and/or adjacent paraspinal tissue and represents 2-7% of all musculoskeletal infections. There are numerous factors, which may facilitate the development of SI including not only advanced patient age and comorbidities but also spinal surgery. Due to the low specificity of signs, the delay in diagnosis of SI remains an important issue and poor outcome is frequently seen. Read More
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    Spinal tuberculosis: Clinicoradiological findings in 274 patients.
    Clin Infect Dis 2018 Jan 11. Epub 2018 Jan 11.
    Department of Neurology, Inkosi Albert Luthuli Central Hospital, Cato Manor, Durban, South Africa.
    Background: Mycobacterium tuberculosis is a major cause of myelopathy and radiculopathy in high TB/HIV prevalent settings. However, a paucity of publications exists on the spectrum of neurological and magnetic resonance imaging (MRI) findings of spinal tuberculosis in these populations.

    Methods: A retrospective study of adults with spinal tuberculosis conducted at a referral center for patients with spinal disease without bony involvement on plain film radiography in South Africa. Read More
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    DISC: Describing Infections of the Spine treated with Ceftaroline.
    J Glob Antimicrob Resist 2018 Jan 11. Epub 2018 Jan 11.
    Case Western Reserve University School of Medicine, Cleveland, OH, USA; Department of Medicine, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA.
    Objectives: Spine infections lead to considerable morbidity and high cost to the global health care system. Currently, the evidence for using ceftaroline, an advanced-generation cephalosporin active against methicillin-resistant Staphylococcus aureus (MRSA), in spine infections is limited.

    Methods: Describing Infections of the Spine treated with Ceftaroline (DISC) is a multicenter retrospective cohort study that evaluated ceftaroline for treating spine infections. Read More
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    Expansile manubriotomy for ventral cervicothoracic junction disease.
    Neurol India 2018 Jan-Feb;66(1):168-173
    Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India.
    Cervicothoracic junction can be approached anteriorly, anterolaterally, posterolaterally, and posteriorly. The anterior approaches in this region best address the ventral vertebral body disease but may cause significant morbidity. Twelve patients with their disease process located ventral to the spinal cord in the cervicothoracic junction underwent expansile manubriotomy and corpectomy. Read More
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    Spondylodiscitis: Diagnosis and Treatment Options.
    Dtsch Arztebl Int 2017 Dec;114(51-52):875-882
    Department for Trauma and Reconstructive Surgery, University Hospital RWTH Aachen; Department I for Internal Medicine, University Hospital Cologne; Center of Orthopedic and Trauma Surgery, University Hospital Cologne; Center for Orthopaedics and Trauma Surgery, Rhein-Maas Klinikum GmbH, Würselen.
    Background: A recent population-based study from Denmark showed that the incidence of spondylodiscitis rose from 2.2 to 5.8 per 100 000 persons per year over the period 1995-2008; the age-standardized incidence in Germany has been estimated at 30 per 250 000 per year on the basis of data from the Federal Statistical Office (2015). Read More
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    Spinal cord injury arising in anaesthesia practice.
    Anaesthesia 2018 Jan;73 Suppl 1:43-50
    Anaesthesia & Critical Care, School of Medicine, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
    Spinal cord injury arising during anaesthetic practice is a rare event, but one that carries a significant burden in terms of morbidity and mortality. In this article, we will review the pathophysiology of spinal cord injury. We will then discuss injuries relating to patient position, spinal cord hypoperfusion and neuraxial techniques. Read More
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    Epidural Metastasis in Malignant Thymoma Mimicking Epidural Abscess: Case Report and Literature Review.
    Korean J Spine 2017 Dec 31;14(4):162-165. Epub 2017 Dec 31.
    Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju, Korea.
    Thymoma and thymic carcinoma are rare epithelial tumors that originate from the thymus gland. Extrathoracic metastases occur in the liver, kidney, and bone in 1% to 15% of patients. Although thymoma and thymic carcinoma exhibit highly aggressive biological behavior, spinal metastasis is rare. Read More
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    Diffuse Nocardial Spinal Subdural Empyema: Diagnostic Dilemma and Treatment Options.
    Cureus 2017 Oct 24;9(10):e1795. Epub 2017 Oct 24.
    Department of Neurosurgery, University of Louisville School of Medicine.
    Nocardiosis of the central nervous system and spine, in particular, is a rare infection with significant morbidity and mortality. Treatment is usually with antibiotics and surgical drainage or biopsy. The authors report a case of a 49-year-old man who presented with chronic lower back pain and paraplegia. Read More
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    Features of Prevertebral Disease in Patients Presenting to a Head and Neck Surgery Clinic with Neck Pain.
    Ann Maxillofac Surg 2017 Jul-Dec;7(2):228-231
    Department of Surgery, Florida Atlantic University, Boca Raton, Florida, USA.
    Introduction: Untreated prevertebral space infections, which can be overlooked because of connections with surrounding spaces, may lead to spinal epidural accumulations that cause cord compression. The aim of this study was to analyze the epidemiologic and diagnostic features of cases of prevertebral disease encountered by head and neck specialists.

    Materials And Methods: The study was designed as a retrospective chart review of 11 patients with prevertebral disease who presented to a head and neck surgery specialist for consultation from 2004 to 2010. Read More
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    Odontoid-sparing transnasal approach for drainage of craniocervical epidural abscess; a novel technique and review of the literature.
    Spine J 2018 Mar 15;18(3):540-546. Epub 2017 Dec 15.
    Helios Klinikum Erfurt, Nordhaeuser St 74, 99089 Erfurt, Germany.
    Background Context: Surgical approaches to the craniovertebral junction (CVJ) are challenging. Available approaches include posterior, transoral, endonasal, and anterior extended retropharyngeal approach. Resection of the odontoid process is necessary to gain access to the pathology posterior to it. Read More
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    Edwardsiella tarda Bacteremia with Psoas and Epidural Abscess as a Food-borne Infection: A Case Report and Literature Review.
    Intern Med 2018 Mar 8;57(6):893-897. Epub 2017 Dec 8.
    Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine, Japan.
    Edwardsiella tarda is commonly isolated from aquatic environments and a variety of animals. We present the first case of E. tarda bacteremia with psoas and epidural abscess. Read More
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    Pyogenic Odontoid Osteomyelitis with Sinus Thrombosis.
    Case Rep Radiol 2017 29;2017:2507645. Epub 2017 Oct 29.
    Department of Neurology, Hofstra Northwell Health, Staten Island University Hospital, Staten Island, NY, USA.
    71/F presented with left sided headaches and neck pain with nuchal rigidity progressively worsening over 3 weeks with no other neurologic symptoms. Odontoid osteomyelitis with epidural abscess was discovered on further workup with neuroimaging. Concurrent jugular vein and transverse sinus venous thrombosis was also found and suspected to be secondary to the pyogenic odontoid osteomyelitis. Read More
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    Pyogenic vertebral osteomyelitis of the elderly: Characteristics and outcomes.
    PLoS One 2017 5;12(12):e0188470. Epub 2017 Dec 5.
    Department of Internal Medicine and Infectious Diseases, University Hospital of Tours, Hôpital Bretonneau, Tours, France.
    Background: The incidence of pyogenic vertebral osteomyelitis (PVO) has increased over the past two decades. One possible cause of this increase is the aging of the population, which results in more comorbidities in high income countries.

    Objective: To better characterize the clinical presentation and outcome of PVO in the elderly. Read More
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    Epidural abscess imitating recurrent pilonidal sinus: a case report.
    G Chir 2017 May-Jun;38(3):135-138
    Pilonidal sinus or pilonidal cyst is a common benign disease, affecting mostly young working men. We present the first case of an epidural abscess imitating pilonidal sinus. A 33-year old male, suffering from previously undiagnosed and untreated diabetes mellitus (DM), presented to our emergency department (ER), one month after open surgical treatment of pilonidal sinus, due to weakness and fever. Read More
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    Rehabilitation Outcomes in Spinal Abscess Patients With and Without a History of Intravenous Substance Abuse.
    Am J Phys Med Rehabil 2017 Nov 20. Epub 2017 Nov 20.
    Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, KY, USA.
    Objective: To compare functional outcomes of acute inpatient rehabilitation for spinal epidural abscess (SEA) patients with and without history of intravenous substance abuse (IVSA).

    Design: Retrospective case series study in freestanding rehabilitation hospital.

    Methods: Charts of 28 SEA patients admitted from 01/2012 to 9/2015: 13 with IVSA and 15 without IVSA were reviewed. Read More
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    Autoantibodies to Granulocyte-Macrophage Colony-Stimulating Factor Associated With Severe and Unusual Manifestations of Infections.
    Open Forum Infect Dis 2017 5;4(4):ofx211. Epub 2017 Oct 5.
    National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
    infections, especially including those with severe clinical manifestations, may be related to underlying host immunologic factors. We present 2 cases with autoantibodies to granulocyte-macrophage colony-stimulating factor (GM-CSF), a key cytokine in macrophage function. Immunologic evaluation for anti-GM-CSF antibodies may be important to inform management and counseling. Read More
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    Safety and Complications of Cervical Epidural Steroid Injections.
    Phys Med Rehabil Clin N Am 2018 Feb 7;29(1):155-169. Epub 2017 Oct 7.
    Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, 2201 Children's Way Suite 1318, Nashville, TN 37212, USA.
    Serious neurologic complications following cervical transforaminal epidural steroid injections (CTFESI) and cervical interlaminar epidural steroid injections (CILESI) have been reported. For CILESI, this is caused by aberrant needle placement or space-occupying lesions, such as hematoma or abscess. For CTFESI, this is caused by embolic infarct when inadvertent intra-arterial injection of particulate steroids has occurred. Read More
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    Multilevel lumbar spine infection due to poor dentition in an immunocompetent adult: a case report.
    J Med Case Rep 2017 Nov 22;11(1):328. Epub 2017 Nov 22.
    Department of Anesthesiology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN, 55905, USA.
    Background: Although spinal infections have been reported following dental procedures, development of a spinal infection attributed to poor dentition without a history of a dental procedure in an immunocompetent adult has not been previously reported. Here we provide a case report of a multilevel lumbar spine infection that developed in an immunocompetent adult with poor dentition.

    Case Presentation: A 63-year-old white male man with past medical history of hypertension presented to a hospital emergency department with a 4-month history of progressively worsening low back pain. Read More
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