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The patient
a doctor came to the
hospital 27-December from Iraq with longstanding history since 1985
of CCS with malacia of the spinal cord. As he claims, his condition
was acceptable until he underwent labcholi 01-November-2005, after
what he got severe quadriparesis with inability to walk. MRI and
X-rays performed before and after the labcoli, showing that in
addition to the CCS, he got pathological fracture of C5 with more
damage to the spinal cord. On examination, the patient had
parahypalgesia below C4 and quadriparesis at the same level with the
power more affected in the left side. There were no micturition or
defecation problems.
Considering that his fracture is a pathologic
one, it was decided to perform corporectomy of C5 with removal of
the disci C4-5 and C5-6 and the material was sent to histological
studies. So as not to have problems with possible osteomyelitis of
the lesion, a 24 mm fibular graft was harvested from his right
leg and using Syntex cervical miniplate, the graft was fixed to the
device and both were applied to fill the gap and to fuse C4 and C6
accordingly and gain acceptable bony alignment.
The power of the right upper limb and the distal
muscles of both lower limbs improved immediately after surgery. The
other muscles in the next operative day remained the same and the
patient feeling that, the proximal muscles of the left leg became
more weak.
The patient came 5 days after surgery with some
further improvement of the upper limbs with the histologic result
taken during the surgery confirming the presence of osteomyelitis
without presence of malignancy, which explain the cause of his
pathologic fracture during anaesthesia for the performed labcholi.
Comment:
This is an example, that deformity of the spine
with subsequent disc extrusion and the pathologic fracture in this
case could be osteomyelitis of the bony structures or the endplates.
This must be considered in some cases, when, especially the patient
progress fulminating picture of discitis or osteomyelitis after
surgery. The surgery in these circumstances provoke the infectious
nidus and over several weeks the patient start to progress
escalation of pain and etc. problems. | 
