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KMID : 1150120200060010025
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Asian Journal of Pain
2020 Volume.6 No. 1 p.25 ~ p.29
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Cervical Spondylodiscitis with Neurologic Deterioration after Percutaneous Cervical Nucleoplasty
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Kim Bo-Seob
Han Moon-Soo
Lee Gwang-Jun
Lee Seul-Kee
Moon Bong-Ju
Lee Jung-Kil
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Abstract
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Percutaneous cervical nucleoplasty (PCN) has proven to be a safe and effective technique for the management of the cervical herniated or bulging discs. The incidence of cervical spondylodicitis (CSD) after PCN is rare. Case 1: A 53-year-old male patient was admitted with right arm motor weakness, severe posterior neck pain. He diagnosed with a C5-6 bulging disc and underwent a PCN two months prior to admission to our hospital. Laboratory tests revealed WBC counts and CRP levels, but his erythrocyte ESR was mildly elevated to 42 mm/hr. MRI showed a CSD at the C5-6 level. The patient underwent an anterior cervical C5 corpectomy and fusion. A microbiological culture revealed the presence of Propionibacterium acnes. Case 2: A 51-year-old female patient was admitted with quadriparesis. She was diagnosed with a C6-7 bulging disc and underwent a PCN two weeks prior to admission to our hospital. Laboratory tests revealed and elevated WBC count of 13.1×103/mm3, elevated ESR of 70 mm/hr, and elevated CRP of 10.1 mg/dL. The MRI showed a high signal intensity around the C5-6 vertebral body and epidural fluid collection on the axial image. The patient underwent a C6-7 anterior cervical discectomy and. No microbes were identified in blood or pus cultures. Clinicians should consider CSD, if a patient’s neurologic symptoms have deteriorated within 8 weeks after PCN. If clinical and laboratory tests show any indication of CSD, MRI should be performed facilitating appropriately timed treatment in order to prevent neurological sequelae.
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KEYWORD
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Cervical spondylodiscitis, Percutaneous, Nucleoplasty, Discitis, Percutaneous cervical nucleoplasty
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