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- postoperative spondylodiscitis
- spinal surgery
- herniated lumbar disc
- clinical neurology
Postoperative spondylodiscitis is a well-known complication of lumbar disc surgery, affecting between 0.1 and 1.7% of patients.1 It is usually due to contamination by skin flora. Usual pathogens are Staphylococcus aureus and Staphylococcus epidermidis.
In industrialised countries, brucellosis is a rare condition, almost exclusively found in cattle-exposed patients such as farmers, shepherds and veterinarians. Brucella osteomyelitis is rarer still, although it mostly affects the spine.
History and presentation
A 43-year-old man had undergone dorsolateral transmuscular sequestrectomy and nucleotomy including Nebacetin-irrigation L3/4 for an extraforaminal left-sided herniated lumbar disc (figure 1A). The early postoperative course was uneventful.
Two months later, he appeared with a 4-week history of lower back pain, fever, chills and profuse sweating. The plain x-ray showed no signs of spondylodiscitis, but the initial MRI revealed typical findings of spondylodiscitis at L3/4 (figure 1B, C). The patient was ordered …