An uncommon cause of paraplegia: Salmonella spondylodiskitis

Abstract

Background/objective: Salmonella spondylodiskitis is an uncommon type of vertebral infection. The aim of this study was to present a case of progressive paraplegia caused by Salmonella spondylodiskitis and epidural abscess after endoscopic cholecystectomy.

Methods: The patient underwent posterior instrumentation and posterior fusion between T6 and T12, hemilaminotomies at levels T8-T9-T10, and drainage of the abscess. Through a left thoracotomy, anterior T8-T10 corpectomy, debridement, anterior stabilization, and fusion were conducted.

Results: Fifteen months later, final follow-up showed no complications secondary to the vertebral and hip surgeries, and neurological status improved to Frankel grade E. Laboratory investigations showed no evidence of Salmonella infection.

Conclusion: Immunocompromised patients who undergo endoscopic intervention are vulnerable to Salmonella infections. One must consider Salmonella infection in those who develop acute progressive spondylodiskitis.

Figure 1. Sagittal (a) and axial (b) MRI studies showing spondylodiskitis compressing the spinal cord at levels T8, T9, and T10, anteriorly and posteriorly.

Figure 2. Postoperative anteroposterior (a) and lateral (b) radiographs of this patient, who underwent posterior instrumentation and posterior fusion between T6 and T12, hemilaminotomies at levels T8, T9, and T10, and drainage of the abscess, followed by anterior T8–T10 anterior corpectomy, debridement and anterior stabilization, and fusion.