title: Vertebral Osteomyelitis Caused by Mycobacterium abscessus Surgically Treated Using Antibacterial Iodine-Supported Instrumentation.
abstract: Mycobacterium abscessus infections rarely develop in healthy individuals, and mostly they occur in immunocompromised hosts. Vertebral osteomyelitis due to Mycobacterium abscessus is very rare and only three previous cases of spinal infection caused by Mycobacterium abscessus have been reported. Mycobacterium abscessus isolates are uniformly resistant to antituberculous agents and can display a virulent biofilm-forming phenotype. The patient was a 67-year-old woman with vertebral osteomyelitis of the L1-2. She was healthy without immune-suppressed condition, history of trauma, or intravenous drug use. The smear examination of the specimen harvested by CT-guided puncture of the paravertebral abscess revealed Mycobacterium abscessus. Her disease condition did not abate with conservative treatment using antimicrobial chemotherapy. Radical debridement of the vertebral osteomyelitis and anterior reconstruction from T12 to L2 using antibacterial iodine-supported instrumentation were performed. Chemotherapy using clarithromycin, amikacin, and imipenem was applied for 6 months after surgery as these antibiotics had been proven to be effective to Mycobacterium abscessus after surgery. Two years after surgery, the infected anterior site healed and bony fusion was successfully achieved without a recurrence of infection.
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
authors.forename: Satoshi
authors.identifier: 0000-0003-4762-5932
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
authors.forename: Hideki
authors.identifier: 0000-0003-0515-540X
authors.initials: H
authors.lastname: Murakami
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Demura
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
authors.forename: Katsuhito
authors.identifier: 0000-0002-7488-3139
authors.initials: K
authors.lastname: Yoshioka
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
authors.forename: Hiroyuki
authors.identifier: 0000-0003-0568-5419
authors.initials: H
authors.lastname: Hayashi
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
authors.forename: Noriaki
authors.identifier: 0000-0002-3415-5823
authors.initials: N
authors.lastname: Yokogawa
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
authors.forename: Xiang
authors.identifier: 0000-0001-5016-4917
authors.initials: X
authors.lastname: Fang
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
authors.forename: Hiroyuki
authors.identifier: 0000-0003-0730-7921
authors.initials: H
authors.lastname: Tsuchiya