Pyogenic spondylitis in an S1-S2 immobile segment.
METHODS
A case of pyogenic spondylitis in S1-S2 is presented.


OBJECTIVE
To describe the diagnosis and management of this rare spondylitis.


BACKGROUND
The segment including the first and second sacral vertebrae is not mobile. Therefore, discitis of S1-S2 and adjacent spondylitis is very rare. To the authors' knowledge, this is the first reported case of infectious spondylitis in an immobile segment: S1-S2.


METHODS
In addition to radiography and bone scintigraphy, magnetic resonance imaging was used to confirm the diagnosis. Changes consistent with infectious spondylitis were shown, including an epidural abscess.


RESULTS
The patient was treated with laparoscopic drainage and biopsy. Staphylococcus aureus was cultured, and adequate antibiotics were administered. Repeat magnetic resonance imaging at approximately 4 months demonstrated normal signal intensity and disappearance of the abscess.


CONCLUSIONS
Findings from this study show that pyogenic spondylitis can occur in immobile S1-S2.
Department of Orthopaedic Surgery, Ewha Women's University, Seoul, Korea. ydkoh@mm.ewha.ac.kr
Y D
YD
Koh
J O
JO
Kim
C H
CH
Choi
H S
HS
An
D000293:Adolescent; D000900:Anti-Bacterial Agents; D001706:Biopsy; D003646:Debridement / Q000379:methods*; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D004724:Endoscopy; D020802:Epidural Abscess / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011859:Radiography; D011877:Radionuclide Imaging; D012447:Sacrum / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D013166:Spondylitis / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D013211:Staphylococcus aureus / Q000302:isolation & purification
D000900:Anti-Bacterial Agents