Nepal Journal of Neuroscience
Official Journal of Nepalese Society of Neurosurgeons
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Pyogenic Spondylitis Treated by Multi-staged Surgery: Case Report.

Satoshi Yamaguchi, MD, Junichi Mizuno, MD, Kuniki Eguchi, MD, Masaaki Takeda, MD, Kaoru Kurisu, MD
Satoshi Yamaguchi, MD, PhD Department of Neurosurgery Hiroshima University Graduate School of Biomedical Sciences Hiroshima, Japan Junichi Mizuno, MD, PhD Department of Neurosurgery Fujita Health University Aichi, Japan Kuniki Eguchi, MD, PhD Department of Neurosurgery Hiroshima University Graduate School of Biomedical Sciences Hiroshima, Japan Masaaki Takeda, MD Department of Neurosurgery Hiroshima University Graduate School of Biomedical Sciences Hiroshima,

Abstract
Pyogenic spondylitis is an acute infencitious condition with rapid progession and worse clinical outcome if not detected in time. A 63-year-old female, presented with fever, middle-back pain and acutely progressing paraplegia. Magnetic resonance imaging (MRI) showed signs of pyogenic spondylitis. Decompressive laminectomy was performed as an emergency treatment. Follow-up computed tomography (CT) showed progression of local kyphosis at the thoracic lesion. Under control of infection with antibiotics, she underwent two more surgeries to stabilize the thoracic spine. Finally, she became ambulant after rehabilitation. A case has been reported here for its rarity and difficulty in formulating surgical strategy has been discussed.

Key Words: fusion and fixation, laminectomy, multi-staged surgery, pyogenic spondylitis