Conservative management of pyogenic osteomyelitis of the occipitocervical junction.
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.
Spies
E H
EH
Department of Orthopedic Surgery, University of Freiburg, Germany. Spies@sum2.ruf.uni.freiburg.de
Stücker
R
R
Reichelt
A
A
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
D000900:Anti-Bacterial Agents