title: Conservative management of pyogenic osteomyelitis of the occipitocervical junction.
abstract: METHODS
  A report of three cases of pyogenic osteomyelitis of the occipitocervical junction.
  
  
  OBJECTIVE
  To describe the conservative management of pyogenic osteomyelitis of the occipitocervical junction.
  
  
  BACKGROUND
  The therapeutic approach to inflammation of the upper cervical spine is controversial.
  
  
  METHODS
  Pyogenic osteomyelitis of the occipitocervical junction is rare. In the orthopedic literature, only a few case reports with variable treatment methods are available. Three patients with pyogenic osteomyelitis of the occipitocervical junction were treated nonoperatively. Intravenous antibiotic therapy was begun after direct cultures or blood cultures were obtained. Early mobilization was accomplished by application of a halo vest.
  
  
  RESULTS
  Two patients recovered by spontaneous fusion of the occipitocervical junction. Instability developed in the spine of one patient, but she refused further treatment.
  
  
  CONCLUSIONS
  Diagnosis of osteomyelitis of the upper cervical spine is difficult. In cases with absence of neurologic symptoms or spinal abscess formation, treatment can be nonoperative.
authors.affiliation: Department of Orthopedic Surgery, University of Freiburg, Germany. Spies@sum2.ruf.uni.freiburg.de
authors.forename: E H
authors.initials: EH
authors.lastname: Spies
authors.forename: R
authors.initials: R
authors.lastname: Stücker
authors.forename: A
authors.initials: A
authors.lastname: Reichelt
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents; D001706:Biopsy; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000473:pathology; D010019:Osteomyelitis / Q000175:diagnosis / Q000628:therapy*; D012149:Restraint, Physical / Q000379:methods*; D013122:Spinal Diseases / Q000175:diagnosis / Q000628:therapy*; D013492:Suppuration / Q000175:diagnosis / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents