Cargando…

Pyogenic Spondylitis Caused by Methicillin-Resistant Staphylococcus aureus Associated with Tracheostomy followed by Resection of Ossification of the Anterior Longitudinal Ligament

Symptomatic ossification of the anterior longitudinal ligament (OALL) is rare. However, when the osteophyte enlarges and obstructive symptoms occur, the patient may require surgery. We present a case of pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus associated with trache...

Descripción completa

Detalles Bibliográficos
Autores principales: Hongo, Michio, Miyakoshi, Naohisa, Fujii, Masashi, Kasukawa, Yuji, Ishikawa, Yoshinori, Kudo, Daisuke, Shimada, Yoichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835278/
https://www.ncbi.nlm.nih.gov/pubmed/29670792
http://dx.doi.org/10.1155/2018/9076509
_version_ 1783303786126639104
author Hongo, Michio
Miyakoshi, Naohisa
Fujii, Masashi
Kasukawa, Yuji
Ishikawa, Yoshinori
Kudo, Daisuke
Shimada, Yoichi
author_facet Hongo, Michio
Miyakoshi, Naohisa
Fujii, Masashi
Kasukawa, Yuji
Ishikawa, Yoshinori
Kudo, Daisuke
Shimada, Yoichi
author_sort Hongo, Michio
collection PubMed
description Symptomatic ossification of the anterior longitudinal ligament (OALL) is rare. However, when the osteophyte enlarges and obstructive symptoms occur, the patient may require surgery. We present a case of pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus associated with tracheostomy followed by resection of OALL. A 69-year-old woman with OALL complained of dysphagia and suffocation, which was caused by prominent OALL at C4-5. Tracheostomy was performed, followed by osteophytectomy 6 weeks later. Two months after osteophytectomy, she complained of muscle weakness of the extremities, neck pain, and elevated temperature. Magnetic resonance imaging showed an intensity change at the C4-5 vertebrae and an epidural abscess that was causing cord compression requiring urgent decompression. Cultures identified methicillin-resistant Staphylococcus aureus. As osteolytic change and muscle weakness gradually progressed, she underwent anterior and posterior reconstruction with an autograft and instrumentation. Bone union was confirmed at 1 year postoperatively with improvement in neurological status. OALL has potentially the risk of airway obstruction. Therefore, appropriate diagnosis and prompt osteophytectomy are needed in cases of a large prominent ossification that puts the patient at risk of suffocation. However, it is noted that osteophytectomy following urgent tracheostomy carries the possible risk of infection.
format Online
Article
Text
id pubmed-5835278
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Hindawi
record_format MEDLINE/PubMed
spelling pubmed-58352782018-04-18 Pyogenic Spondylitis Caused by Methicillin-Resistant Staphylococcus aureus Associated with Tracheostomy followed by Resection of Ossification of the Anterior Longitudinal Ligament Hongo, Michio Miyakoshi, Naohisa Fujii, Masashi Kasukawa, Yuji Ishikawa, Yoshinori Kudo, Daisuke Shimada, Yoichi Case Rep Orthop Case Report Symptomatic ossification of the anterior longitudinal ligament (OALL) is rare. However, when the osteophyte enlarges and obstructive symptoms occur, the patient may require surgery. We present a case of pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus associated with tracheostomy followed by resection of OALL. A 69-year-old woman with OALL complained of dysphagia and suffocation, which was caused by prominent OALL at C4-5. Tracheostomy was performed, followed by osteophytectomy 6 weeks later. Two months after osteophytectomy, she complained of muscle weakness of the extremities, neck pain, and elevated temperature. Magnetic resonance imaging showed an intensity change at the C4-5 vertebrae and an epidural abscess that was causing cord compression requiring urgent decompression. Cultures identified methicillin-resistant Staphylococcus aureus. As osteolytic change and muscle weakness gradually progressed, she underwent anterior and posterior reconstruction with an autograft and instrumentation. Bone union was confirmed at 1 year postoperatively with improvement in neurological status. OALL has potentially the risk of airway obstruction. Therefore, appropriate diagnosis and prompt osteophytectomy are needed in cases of a large prominent ossification that puts the patient at risk of suffocation. However, it is noted that osteophytectomy following urgent tracheostomy carries the possible risk of infection. Hindawi 2018-02-18 /pmc/articles/PMC5835278/ /pubmed/29670792 http://dx.doi.org/10.1155/2018/9076509 Text en Copyright © 2018 Michio Hongo et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Hongo, Michio
Miyakoshi, Naohisa
Fujii, Masashi
Kasukawa, Yuji
Ishikawa, Yoshinori
Kudo, Daisuke
Shimada, Yoichi
Pyogenic Spondylitis Caused by Methicillin-Resistant Staphylococcus aureus Associated with Tracheostomy followed by Resection of Ossification of the Anterior Longitudinal Ligament
title Pyogenic Spondylitis Caused by Methicillin-Resistant Staphylococcus aureus Associated with Tracheostomy followed by Resection of Ossification of the Anterior Longitudinal Ligament
title_full Pyogenic Spondylitis Caused by Methicillin-Resistant Staphylococcus aureus Associated with Tracheostomy followed by Resection of Ossification of the Anterior Longitudinal Ligament
title_fullStr Pyogenic Spondylitis Caused by Methicillin-Resistant Staphylococcus aureus Associated with Tracheostomy followed by Resection of Ossification of the Anterior Longitudinal Ligament
title_full_unstemmed Pyogenic Spondylitis Caused by Methicillin-Resistant Staphylococcus aureus Associated with Tracheostomy followed by Resection of Ossification of the Anterior Longitudinal Ligament
title_short Pyogenic Spondylitis Caused by Methicillin-Resistant Staphylococcus aureus Associated with Tracheostomy followed by Resection of Ossification of the Anterior Longitudinal Ligament
title_sort pyogenic spondylitis caused by methicillin-resistant staphylococcus aureus associated with tracheostomy followed by resection of ossification of the anterior longitudinal ligament
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835278/
https://www.ncbi.nlm.nih.gov/pubmed/29670792
http://dx.doi.org/10.1155/2018/9076509
work_keys_str_mv AT hongomichio pyogenicspondylitiscausedbymethicillinresistantstaphylococcusaureusassociatedwithtracheostomyfollowedbyresectionofossificationoftheanteriorlongitudinalligament
AT miyakoshinaohisa pyogenicspondylitiscausedbymethicillinresistantstaphylococcusaureusassociatedwithtracheostomyfollowedbyresectionofossificationoftheanteriorlongitudinalligament
AT fujiimasashi pyogenicspondylitiscausedbymethicillinresistantstaphylococcusaureusassociatedwithtracheostomyfollowedbyresectionofossificationoftheanteriorlongitudinalligament
AT kasukawayuji pyogenicspondylitiscausedbymethicillinresistantstaphylococcusaureusassociatedwithtracheostomyfollowedbyresectionofossificationoftheanteriorlongitudinalligament
AT ishikawayoshinori pyogenicspondylitiscausedbymethicillinresistantstaphylococcusaureusassociatedwithtracheostomyfollowedbyresectionofossificationoftheanteriorlongitudinalligament
AT kudodaisuke pyogenicspondylitiscausedbymethicillinresistantstaphylococcusaureusassociatedwithtracheostomyfollowedbyresectionofossificationoftheanteriorlongitudinalligament
AT shimadayoichi pyogenicspondylitiscausedbymethicillinresistantstaphylococcusaureusassociatedwithtracheostomyfollowedbyresectionofossificationoftheanteriorlongitudinalligament