Two-Stage (Posterior and Anterior) Surgical Treatment of Spinal Osteomyelitis due to Atypical Mycobacteria and Associated Thoracolumbar Kyphoscoliosis in a Nonimmunocompromised Patient

Abstract

A case report of atypical mycobacterial spinal osteomyelitis. To describe a rare case of spinal osteomyelitis and associated thoracolumbar kyphoscoliosis caused by atypical mycobacteria, and successful treatment by a 2-stage surgical intervention. Vertebral osteomyelitis caused by atypical mycobacteria is very rare. The patient was an 18-year-old woman with vertebral osteomyelitis of Th12-L1 caused by Mycobacterium avium complex. Plain radiographs revealed vertebral collapse of Th12, scoliosis, and kyphosis. Two-stage surgical treatment (first: posterior instrumentation; second: anterior debridement and bone graft) was performed. At 5 years after surgery, the patient is almost free of the preoperative symptoms with no evidence of disease recrudescence. Plain radiograph film demonstrated amelioration of scoliosis and kyphosis, and consolidation of the anterior bone graft. A rare case of intractable spinal osteomyelitis due to atypical mycobacteria in a nonimmunocompromised patient was treated successfully with 2-stage surgical treatment.