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Munir Elias 20-12-2013
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Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit  neurosurgery.tv

 

 

19-NOVEMBER-2006  SALEH MERZAH HUSSEIN  67 YEARS  DISCO-OSTEOMYELITIS L3-L4 UNVERIFIED CAUSE.

The patient came to the operating room with history of 7 months of LBP after surgery for pilonidal sinus 24-April-2006. The patient continued to complain of agonizing LBP with bilateral sciatica more in the right. MRI of the lumbar spine performed 1 week ago showed osteomyelitic changes of L3 and L4 bodies with discitis of L3-4. There was no soft tissue component and destruction of the endplates causing moderated compression of the dural sac.

On examination: the patient had weak dorsiflexion both feet more pronounced in the right foot. Percutanous discectomy of L3-4 guided with image-intensifier was performed and the bony and disc material was sent for investigations.

Comments:

1.  Infection could be spread by bloodstream after the surgery for pilonidal sinus. Investigations and biopsy must be done to rule out presence of other ethiological factors.

2. Most of the articles concerning pilonidal sinus complications discuss the recurrence, but such blood stream spread of the lesion to the vertebral bodies rarely mentioned.

 

 

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