Lumbar spine osteolysis: an entity caused by spinal instability.
Presented is a new entity in the spectrum of complications following spinal decompression. It occurs in patients with spinal instability after decompression. Thereafter, instability accelerates, leading to a rapid clinical and radiologic deterioration. The presenting symptoms are back pain and lower extremity weakness, resembling spinal stenosis. Erythrocyte sedimentation rate and temperature remain normal. Radiologically, a distinct form of progressing osteolysis is present. This entity may present a difficult diagnostic problem and is usually diagnosed erroneously as a destructive osteomyelitis. Craig needle biopsy results are normal. Treatment consists of stabilization rather than antibiotic therapy and debridement. It is apparent that patients with spinal instability are to be considered "at risk" as further decompression may accelerate the instability, resulting in progressive osteolysis.
D000368:Aged; D001416:Back Pain / Q000601:surgery; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000150:complications* / Q000209:etiology; D007796:Laminectomy / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D010014:Osteolysis / Q000209:etiology* / Q000601:surgery; D013122:Spinal Diseases / Q000209:etiology / Q000601:surgery; D013123:Spinal Fusion