• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.784-793
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• 2020

Objective : We attempted to compare the incidence of pyogenic spondylitis (PS) and tuberculous spondylitis (TS) between 2007 and 2016. Furthermore, we investigated the patients who underwent surgery in 2016 compared to that in 2007. Methods : We used a nationwide database managed by the Korean National Health Insurance Service (NHIS) in 2007 and 2016. Total 9655 patients with a newly diagnosis of PS or TS were enrolled in PS or TS group. Among them, 1721 patients underwent either fusion or decompression surgery. We analyzed demographic distribution of patients according to gender and age and year of diagnosis. Results : Comparing between 2007 and 2016, the incidence of PS has increased in 2016 than in 2007 (4874 vs. 2431, p<0.0001). Conversely, declination of incidence of TS was discovered in 2016 compared to 2007 (594 vs. 1756, p<0.0001). Females showed predominance over males regarding both PS and TS (5228 vs. 4427, p<0.0001). Among them, the number of PS patients who underwent surgery increased significantly in 2016 relative to that in 2007 (979 vs. 592, p<0.0001). Conclusion : This nationwide study suggests that PS may increase and TS may decrease in Korea. In addition, demand for surgery regarding PS may increase.

• Pediatric Infection and Vaccine
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• v.28 no.3
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• pp.160-167
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• 2021

Pyogenic spondylitis, an extremely rare complication of nontyphoidal Salmonella infection in immunocompetent children, occurs more commonly in patients with hemoglobinopathies such as sickle cell disease or in immunocompromised patients. In this study, we report a case of pyogenic spondylitis in a previously healthy 13-year-old immunocompetent adolescent, who presented with prolonged fever and right upper quadrant pain. Stool culture results comfirmed nontyphoidal Salmonella infection, and the patient was diagnosed with pyogenic spondylitis caused by nontyphoidal Salmonella based on additional imaging studies performed for evaluation of the patient's prolonged fever. This case highlights the importance of culture studies for evaluation of patients with fever of unknown origin and also the importance of detailed investigations for early detection of complications of extra-intestinal infections in patients with an unusual clinical course of salmonellosis.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.348-353
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• 2020

A 68-year-old man presented with a bed sore with pus discharge on lower back. Radiographs showed extensive destruction of the L4 vertebral body. Magnetic resonance imaging (MRI) showed fluid collection with an enhanced wall at the defect of the L4 vertebral body extending into both psoas muscles. The primary diagnosis was neuropathic spondylopathy, but infective spondylitis was not ruled out. Initially, he was treated with antibiotics for two weeks. A follow-up MRI showed no improvement of the abscess, so surgical exploration was done. Charcot spinal arthropathy resulted in extensive vertebral body destruction that may be similar to infectious spondylitis, particularly in the case with fluid accumulation due to rupture of dura.

• The Korean Journal of Pain
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• v.26 no.2
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• pp.181-185
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• 2013

Infective spondylodiscitis is a rare complication that can occur after interventional spinal procedures, of which symptoms are usually back pain and fever. Early diagnosis of infective spondylodiscitis is critical to start antibiotics and to improve prognosis. Laboratory examinations including complet blood cell count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) are conventional tools for the early detection of infectious spondylitis. However, we experienced infective spondylodiscitis after cervical nucleoplasty which did not display any laboratory abnormalities, but was diagnosed through an MRI. A patient with cervical disc herniation received nucleoplasty at C5/6 and C6/7. One month later, the patient complained of aggravated pain. There were neither signs of chill nor fever, and the laboratory results appeared normal. However, the MRI findings were compatible with infectious spondylodiscitis at the nucleoplasty site. In conclusion, infectious spondylodiscitis can develop after cervical nucleoplasty without any laboratory abnormalities. Therefore, an MRI should be taken when there is a clinical suspicion for infection in order to not miss complications after interventional procedures, even if the laboratory findings are normal.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1234-1238
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• 2020

Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is characterized by chondrocalcinosis, which mainly affects the knees, wrists, pelvis, and rarely, the spine. According to previous reports, CPPD crystal deposits display heterogeneous enhancement on MRI. When combined with inflammation of the surrounding soft tissue, strong enhancement by CPPD crystal deposition may appear similar to imaging features of other conditions such as infectious spondylitis. In these conditions, CT plays an important role in differential diagnosis. Here, we present a case of CPPD crystal deposition disease in the ligamentum flavum of the cervical spine that showed intense enhancement on MRI.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.3-12
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• 2024

One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.