Abstract
Pyogenic infection of the UCS is very rare; however, it can have a major impact on the health of the patient. Purulent destruction of bone and ligaments can lead to a life-threatening AA instability. Diagnosis is based on general signs of infection and symptoms and signs of local disease. Fever together with neck pain related to head movement must lead to a proper radiographic evaluation. The determination of etiological agent and its antibiotic (ATB) sensitivity is crucial. The treatment composes of either a conservative approach of long-term ATB administration and hard external bracing or active surgical pus drainage, bone debridement followed by instrumentation. If treated properly, the prognosis of purulent UCS infection is very good in the majority of cases.
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References
Ahlback, S., Collert, S.: Destruction of the odontoid process due to atlanto-axial pyogenic spondylitis. Acta Radiol Diagn (Stockh) 10, 394–400 (1970)
Behari, S., Nayak, S.R., Bhargava, V.: Craniocervical tuberculosis: protocol of surgical management. Neurosurgery 52, 72–80 (2003). discussion 80-71
Bhojraj, S.Y., Shetty, N., Shah, P.J.: Tuberculosis of the craniocervical junction. J Bone Joint Surg Br 83, 222–225 (2001)
Busche, M., Bastian, L., Riedemann, N.C.: Complete osteolysis of the dens with atlantoaxial luxation caused by infection with Staphylococcus aureus: a case report and review of the literature. Spine (Phila Pa 1976) 30, E369–E374 (2005)
Edwards, R.J., David, K.M., Crockard, H.A.: Management of tuberculomas of the craniovertebral junction. Br J Neurosurg 14, 19–22 (2000)
Forsythe, M., Rothman, R.H.: New concepts in the diagnosis and treatment of infections of the cervical spine. Orthop Clin North Am 9, 1039–1051 (1978)
Frederickson, B., Yuan, H., Olans, R.: Management and outcome of pyogenic vertebral osteomyelitis. Clin Orthop Relat Res 131, 160–167 (1978)
Gormley, W., Rock, J.: Spontaneous atlantoaxial osteomyelitis: no longer a rare case? Case report. Neurosurgery 35, 132–135 (1994). discussion 135-136
Handmaker, H., Leonards, R.: The bone scan in inflammatory osseous disease. Semin Nucl Med 6, 95–105 (1976)
Heary, R.F., Hunt, C.D., Wolansky, L.J.: Rapid bony destruction with pyogenic vertebral osteomyelitis. Surg Neurol 41, 34–39 (1994)
Keller, T.: Victor Horsley’s surgery for cervical caries and fracture. The centennial anniversary. Spine (Phila Pa 1976) 21, 398–401 (1996)
Lam, C.H., Ethier, R., Pokrupa, R.: Conservative therapy of atlantoaxial osteomyelitis. A case report. Spine (Phila Pa 1976) 21, 1820–1823 (1996)
Leach, R.E., Goldstein, H.H., Younger, D.: Osteomyelitis of the odontoid process. A case report. J Bone Joint Surg Am 49, 369–371 (1967)
Limbird, T.J., Brick, G.W., Boulas, H.J., et al.: Osteomyelitis of the odontoid process. J Spinal Disord 1, 66–74 (1988)
Malawski, S.K., Lukawski, S.: Pyogenic infection of the spine. Clin Orthop Relat Res 272, 58–66 (1991)
Malkins, G.H., Abbot, F.C.: On acute primary osteomyelitis of the vertebrae. Ann Surg 23, 510–539 (1896)
Noguchi, S., Yanaka, K., Yamada, Y.: Diagnostic pitfalls in osteomyelitis of the odontoid process: case report. Surg Neurol 53, 573–578 (2000). discussion 578-579
Ottolenghi, C.E., Schajowicz, F., Deschant, F.A.: Aspiration biopsy of the cervical spine. Technique and results in thirty-four cases. J Bone Joint Surg Am 46, 715–733 (1964)
Palestro, C.J., Kim, C.K., Swyer, A.J., et al.: Radionuclide diagnosis of vertebral osteomyelitis: indium-111-leukocyte and technetium-99m-methylene diphosphonate bone scintigraphy. J Nucl Med 32, 1861–1865 (1991)
Sapico, F.L., Montgomerie, J.Z.: Pyogenic vertebral osteomyelitis: report of nine cases and review of the literature. Rev Infect Dis 1, 754–776 (1979)
Sapico, F.L., Montgomerie, J.Z.: Vertebral osteomyelitis. Infect Dis Clin North Am 4, 539–550 (1990)
Sinha, S., Singh, A.K., Gupta, V.: Surgical management and outcome of tuberculous atlantoaxial dislocation: a 15-year experience. Neurosurgery 52, 331–338 (2003). discussion 338–339
Spies, E.H., Stucker, R., Reichelt, A.: Conservative management of pyogenic osteomyelitis of the occipitocervical junction. Spine (Phila Pa 1976) 24, 818–822 (1999)
Suchomel, P., Buchvald, P., Barsa, P.: Pyogenic osteomyelitis of the odontoid process: single stage decompression and fusion. Spine (Phila Pa 1976) 28, E239–E244 (2003)
Teegala, R., Kumar, P., Kale, S.S.: Craniovertebral junction tuberculosis: a new comprehensive therapeutic strategy. Neurosurgery 63, 946–955 (2008). discussion 955
Ueda, Y., Kawahara, N., Murakami, H.: Pyogenic osteomyelitis of the atlas: a case report. Spine (Phila Pa 1976) 34, E342–E345 (2009)
Venger, B.H., Musher, D.M., Brown, E.W., et al.: Isolated C-2 osteomyelitis of hematogenous origin: case report and literature review. Neurosurgery 18, 461–464 (1986)
Wiedau-Pazos, M., Curio, G., Grusser, C.: Epidural abscess of the cervical spine with osteomyelitis of the odontoid process. Spine (Phila Pa 1976) 24, 133–136 (1999)
Zigler, J.E., Bohlman, H.H., Robinson, R.A., et al.: Pyogenic osteomyelitis of the occiput, the atlas, and the axis. A report of five cases. J Bone Joint Surg Am 69, 1069–1073 (1987)
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Suchomel, P., Choutka, O. (2011). Non Specific Inflammation. In: Reconstruction of Upper Cervical Spine and Craniovertebral Junction. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-13158-5_17
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