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KMID : 0361619720070030327
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Journal of the Korean Orthopaedic Association
1972 Volume.7 No. 3 p.327 ~ p.332
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Clinical Observation of Pyogenic Osteomyelitis of the Spine
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Park,Chang-Kyu
Kwon,Chil-Soo/Kim,Key-Yong
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Abstract
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INTRODUCTION
The earlier Wilensky(1929), Kulowski(1936), and Trueta(1944) reported the pyogenic osteomyelitis of the spine, and Hense & Coventry(1956) reported 185 cases, Garcia(1960) 40 cases, Gilmour(1962) 328 cases, Chung and Lee(1964) 4 cases, Chung et al (1966) 10 cases, and Kim et al(1971) 4 cases.
In this report four cases of pyogenic osteomyelitis of the spine treated at the Department of Orthopedic Surgery, the National Medical Center, Seoul, Korea during the years in 1959 to 1971 is presented with brief discussion.
CASE PRESENTATION
Though the incidence of pyogenic spondylitis as well as tuberculosis of the spine have been considerably reduced in late years in this country. However, pyogenic spondylitis still give rise a problem for orthopedic profession to establish proper diagnosis, and subsequent treatment.
Case 1: A 42-year-old farmer visited Out Patient Clinic in September 1969 with chief complaint of low back pain as well as limited motion of the back.
The brief history revealed that in June 1958 pain developed incidiously on the mid back associated with generalized fever, and shortly afterward abscess was formed on the back. The abscess was treated with incision and drainage and healed. The following
four months he was not able to lie on his back due to pain on the back, and he could manage only walking for toilet.
Physical examination showed a slight gibbus on the thoracolumbar junction, where upon tenderness was demonstrated and no abnormal neurologic findings were observed.
Roentgenogram showed a deformed contour with destructive changes in the lower part of the Th 12 and the upper part of the L1 bodies with narrowing of the intervertebral space and with lateral bridge on the right side. Chest was free.
Serial sedimentation rate were over .100 upto 130 mm/h.. Direct smear and culture of acid fast bacillus in the catheterized urine were negative.
The impression was a pyogenic osteomyelitis of the spine. In order to remove the lesion and to establish the diagnosis, radical curettage was perfo￢rmed through costotransversectomy in January 1960. Small amount of yellowish, thin pus and some amount of granulation tissue were found from the focus.
Bacteriology report from the operative specimen proved Staphylococcus aureus which was sensitive to Aureomycin, Tetracycline and Terramycin. And acid fast bacillus was not proved. Histopathology revealed a picture of nonspecific chronic osteomyelitis.
After the operation the patient was treated with Aureomycin. One week after the operation he became able to be up and about, and he was disch.
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KEYWORD
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