Spondylitis following vertebroplasty: a case report.
OBJECTIVE
Spondylitis is a rare complication of vertebroplasty with only one case report having been published to date. We report a further case of spondylitis after vertebroplasty that was managed successfully with conservative therapy.


METHODS
The clinical course of a 55-year-old patient with secondary osteoporosis due to liver cirrhosis from alcohol abuse is reported, in whom percutaneous vertebroplasty of three fractured vertebral bodies (L3-L5) was complicated by spondylitis at these levels.


RESULTS
Spondylitis of L3-L5 with paravertebral abscess formation and progressive collapse of L5 was detected by magnetic resonance imaging (MRI). Treatment consisted of percutaneous aspiration of the paravertebral abscess and antibiotic therapy. No bacteria was identified despite cultures have been taken before antibiotic treatment. The patient was treated with intravenous ciprofloxacin and consecutive clindamycin for a total of 3 months. One year after the infection the MRI signs of spondylitis have resolved without further collapse of L5. Painlevels have improved significantly, allowing the patient to return to work, but are still higher than immediately after vertebroplasty.


CONCLUSIONS
Spondylitis is a rare complication of vertebroplasty. In the presented case a satisfactory result could be achieved through conservative antibiotic therapy and restriction of movement.
Schmid
Katharina E
KE
Department of Neurosurgery, Berufsgenossenschaftliche Unfallklinik Murnau, Germany. katharina.schmid@bgu-murnau.de
Boszczyk
Bronek M
BM
Bierschneider
Michael
M
Zarfl
Andreas
A
Robert
Björn
B
Jaksche
Hans
H
D000284:Administration, Oral; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery*; D002939:Ciprofloxacin / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005592:Fracture Fixation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007262:Infusions, Intravenous; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology; D016103:Spinal Fractures / Q000601:surgery*; D013166:Spondylitis / Q000209:etiology* / Q000628:therapy*
D002981:Clindamycin; D002939:Ciprofloxacin