title: Early surgical intervention for spinal infection in patients with malignancy requiring chemotherapy: report of two cases and review of the literature.
abstract: Advances in chemotherapy for various malignancies have contributed to the increased life expectancy of patients. If such a patient has a concurrent infection, his/her oncologist would hesitate to perform prompt chemotherapy owing to the risk of inducing sepsis. Therefore, the treatment of infection would have priority over initiating chemotherapy for the malignancy. We present a 69-year-old female with malignant lymphoma requiring prompt chemotherapy who also demonstrated spinal infection with Mycobacterium tuberculosis and a 66-year-old male with esophageal cancer who also demonstrated spinal infection with Staphylococcus aureus. Anterior debridement and interbody fusion were performed for both patients. One patient died of malignant lymphoma 4 years after surgery, and the other is still alive and has remained disease-free 4 years after surgery. Saving the life of a patient with malignancy would be difficult without prompt chemotherapy. Conservative treatment for spinal infection requires prolonged antibiotic treatment, and there is no guarantee that the spinal infection would be controlled only with antibiotics. Therefore, early surgical intervention would be an alternative option under such a condition.
authors: Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan, hidekin@med.tottori-u.ac.jp.
authors: Hideki
authors: H
authors: Nagashima
authors: Yoshiro
authors: Y
authors: Nanjo
authors: Atsushi
authors: A
authors: Tanida
authors: Toshiyuki
authors: T
authors: Dokai
authors: Koji
authors: K
authors: Yamane
authors: Ryota
authors: R
authors: Teshima
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003646:Debridement; D004938:Esophageal Neoplasms / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000382:microbiology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000188:drug therapy*; D008297:Male; D009169:Mycobacterium tuberculosis; D013123:Spinal Fusion; D013203:Staphylococcal Infections / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D013211:Staphylococcus aureus; D013997:Time Factors; D014399:Tuberculosis, Spinal / Q000150:complications / Q000382:microbiology / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents