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Collapsed L4 vertebral body caused by brucellosis.

Ekici MA, Ozbek Z, Kazancı B, Güçlü B - J Korean Neurosurg Soc (2014)

Bottom Line: Neural tissue was decompressed and then posterior L3-5 short segment transpedicular screw fixation and stabilization was performed.Brucella melitensis was isolated from microbiologic culture of pathologic specimen.Antibiotic therapy was given as doxycycline 200 mg/day and rifampicin 600 mg/day for 6 months.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey.

ABSTRACT
Brucellosis is caused by gram-negative, aerobic, non-motile, facultative, intracellular coccobacilli belonging to the genus Brucella. A 50-year-old man working as an employee was admitted to neurosurgery clinic with severe low back, radicular right leg pain and hypoesthesia in right L4-5 dermatomes for 2 months. Brucella tube agglutination (Wright) test was positive in serum sample of the patient with a titer of 1/640. Brucella melitensis was isolated from blood culture. X-ray and MRI of the lomber spine showed massive collapse of L4 vertebral body. Neural tissue was decompressed and then posterior L3-5 short segment transpedicular screw fixation and stabilization was performed. Brucella melitensis was isolated from microbiologic culture of pathologic specimen. Antibiotic therapy was given as doxycycline 200 mg/day and rifampicin 600 mg/day for 6 months. Brucellosis is a systemic zoonotic infection and still an important public health problem in many geographical parts of the world. Vertebral body collapse caused by brucellosis occurs very rarely but represents a neurosurgical emergency because of its potential for causing rapidly progressive spinal cord compression and permanent paralysis. Neurosurgeons, emergency department personnel as well as infectious disease specialists should always keep a high index of suspicion and include brucellosis in the differential diagnosis of vertebral body collapse.

No MeSH data available.


Related in: MedlinePlus

Postoperative lateral (A) and AP X-ray (B) showing transpedicular screw fixation on the L3 and L5 vertebral body.
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Figure 2: Postoperative lateral (A) and AP X-ray (B) showing transpedicular screw fixation on the L3 and L5 vertebral body.

Mentions: The patient was taken to the operation emergently a posterior midline approach and bilateral hemilaminotomy were done. Grey-yellow colored pathologic specimen was obtained from vertebral body and epidural space. Neural tissue was decompressed and then posterior L3-5 short segment transpedicular screw fixation and stabilization was performed (Fig. 2). Tricortical iliac crest wedge obtained from the same patient (autograft) was used for fusion. Neurological signs and symtoms of the patient were recovered after the operation. Brucella melitensis was isolated from microbiologic culture of pathologic specimen. Antibiotic therapy was given for brucellar infection as doxycycline 200 mg/day and rifampicin 600 mg/day for 6 months.


Collapsed L4 vertebral body caused by brucellosis.

Ekici MA, Ozbek Z, Kazancı B, Güçlü B - J Korean Neurosurg Soc (2014)

Postoperative lateral (A) and AP X-ray (B) showing transpedicular screw fixation on the L3 and L5 vertebral body.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928349&req=5

Figure 2: Postoperative lateral (A) and AP X-ray (B) showing transpedicular screw fixation on the L3 and L5 vertebral body.
Mentions: The patient was taken to the operation emergently a posterior midline approach and bilateral hemilaminotomy were done. Grey-yellow colored pathologic specimen was obtained from vertebral body and epidural space. Neural tissue was decompressed and then posterior L3-5 short segment transpedicular screw fixation and stabilization was performed (Fig. 2). Tricortical iliac crest wedge obtained from the same patient (autograft) was used for fusion. Neurological signs and symtoms of the patient were recovered after the operation. Brucella melitensis was isolated from microbiologic culture of pathologic specimen. Antibiotic therapy was given for brucellar infection as doxycycline 200 mg/day and rifampicin 600 mg/day for 6 months.

Bottom Line: Neural tissue was decompressed and then posterior L3-5 short segment transpedicular screw fixation and stabilization was performed.Brucella melitensis was isolated from microbiologic culture of pathologic specimen.Antibiotic therapy was given as doxycycline 200 mg/day and rifampicin 600 mg/day for 6 months.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey.

ABSTRACT
Brucellosis is caused by gram-negative, aerobic, non-motile, facultative, intracellular coccobacilli belonging to the genus Brucella. A 50-year-old man working as an employee was admitted to neurosurgery clinic with severe low back, radicular right leg pain and hypoesthesia in right L4-5 dermatomes for 2 months. Brucella tube agglutination (Wright) test was positive in serum sample of the patient with a titer of 1/640. Brucella melitensis was isolated from blood culture. X-ray and MRI of the lomber spine showed massive collapse of L4 vertebral body. Neural tissue was decompressed and then posterior L3-5 short segment transpedicular screw fixation and stabilization was performed. Brucella melitensis was isolated from microbiologic culture of pathologic specimen. Antibiotic therapy was given as doxycycline 200 mg/day and rifampicin 600 mg/day for 6 months. Brucellosis is a systemic zoonotic infection and still an important public health problem in many geographical parts of the world. Vertebral body collapse caused by brucellosis occurs very rarely but represents a neurosurgical emergency because of its potential for causing rapidly progressive spinal cord compression and permanent paralysis. Neurosurgeons, emergency department personnel as well as infectious disease specialists should always keep a high index of suspicion and include brucellosis in the differential diagnosis of vertebral body collapse.

No MeSH data available.


Related in: MedlinePlus