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Video-assisted thoracoscopic surgery as a diagnostic and therapeutic instrument in non-tubercular spondylodiscitis

Deniece Détillon,1 Hans de Groot, MD,1 Eric Hoebink, MD,2 Rob Versteylen, MD,3 Eelco Veen, MD, PhD

1Department of Surgery, Amphia Hospital, Breda, Netherlands 2Department of Orthopaedic Surgery, Amphia Hospital, Breda, Netherlands 3Department of Radiology, Amphia Hospital, Breda, Netherlands

Abstract

Background

Spondylodiscitis refers to an infection of one or more intervertebral disks and vertebrae, most commonly caused by tuberculosis. Initial therapy for spondylodiscitis is drug treatment. Indications for surgical treatment include compression of neural elements, spinal instability or severe deformities. When surgery is indicated, an open technique is still the standard, although video-assisted thoracoscopic surgery (VATS) is described in cases of thoracic disk herniation, scoliosis and tubercular spondylitis.

Case report

We report a case of a 79-year-old man with progressive back pain, paraparesis and paresthesias in both legs. During assessment, spondylodiscitis with spinal cord compression was diagnosed. Immediate surgical decompression took place by means of VATS. Culture of the tissue obtained revealed Proteus mirabilis. Blood and urine cultures also revealed Proteus mirabilis, a rare cause of spondylodiscitis with an occurrence rate of 0.9%.

Conclusion

VATS offered a minimally invasive access to obtain the diagnosis of pyogenic spondylodiscitis following urosepsis with Proteus mirabilis. Moreover, it provided treatment with abscess drainage and decompression of the spinal cord.

keywords: 
Video-assisted thoracoscopic surgery, Spondylodiscitis, Thoracic spine, Proteus mirabilis
Volume 9 Article 55
doi: 
10.14444/2055