TY  - JOUR
AU  - Cañas, Rafael García
AU  - Areta Jiménez, Francisco Javier
AU  - Moro, Carlos Rodríguez
AU  - López, José Luis Bernácer
AU  - Soriano, Javier Cobo
AU  - Walther, Fernando Álvarez-Sala
PY  - 2019
TI  - Multi-stage surgery for a multiple-level spondylodiscitis caused by multidrug-resistant Mycobacterium avium complex
JF  - Journal of Spine Surgery; Vol 5, No 1 (March 22, 2019): Journal of Spine Surgery
Y2  - 2019
KW  - 
N2  - The objective of this article is to report a rare case of atypical mycobacterial spinal spondylodiscitis with multiple-level involvement and the successful treatment by multi-stage surgical intervention. Reports on the surgical management of atypical mycobacterial spondylodiscitis are lacking. A 71-year-old woman with a confirmed diagnosis of multiple-level spondylodiscitis of L2–L3 and L5–S1 caused by Mycobacterium avium complex (MAC). The patient underwent a two-stage surgical treatment (first: posterior instrumentation; second: anterior debridement with anterior lumbar interbody fusion). At  1 year after surgery, the patient suffered a proximal junctional failure secondary to a vertebral fracture that was solved with a proximal extension of the fusion using a percutaneous technique. The patient was successfully discharged with good pain control, satisfactory correction, no neurologic complications and an overall satisfactory outcome. A rare case of antibiotic-resistant multi-level spondylodiscitis due to MAC was treated successfully with multi-stage surgical treatment. Surgery in this patient group remains challenging due to the technical complexities and the difficulty of choosing the instrumentation levels.
UR  - https://jss.amegroups.org/article/view/4482