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Fracture of the Lumbar Spine Associated with Ureteral Injury Mimicking Spondylodiscitis Followed by Cervical Spine Fracture in Patient with Ankylosing Hyperostosis – Lumbar Fusion

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This article is a case report of a patient with ankylosing spinal hyperostosis (ASH) and a lumbar spine fracture complicated by ureteral injury, which initially presented as spondylodiscitis with osteomyelitis features and retroperitoneal abscess formation. The patient, a 59-year-old man, experienced abdominal pain three weeks after a fall and was diagnosed with a three-column fracture at the L3/L4 level and ASH. Surgery was performed to address the fracture, but postoperative imaging revealed a ureteral injury, which was subsequently treated. Two years later, the patient sustained a low-energy fall and presented with tetraparesis. CT scans revealed a three-column fracture at the C5/C6 level, and surgery was performed. This case report highlights the rare occurrence of both lumbar and cervical spine fractures in the same patient, as well as the potential for retroperitoneal injury in ASH patients. The atypical clinical presentation of spondylodiscitis- and osteomyelitis-like features should also be considered

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Published article

The purpose of this case report is to describe the case of a patient with ankylosing spinal hyperostosis (ASH) and lumbar spine fracture complicated by ureteral injury mimicking spondylodiscitis with osteomyelitis features and retroperitoneal abscess formation followed by the cervical spine fracture. A consecutive analysis and summary of the medical history, radiological documentation, operative procedure, complications, and outcomes were performed. A 59-year-old man presented with abdominal…

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J Clin Med. 2023 Nov 5;12(21):6937. doi: 10.3390/jcm12216937.ABSTRACTThe purpose of this case report is to describe the case of a patient with ankylosing spinal hyperostosis (ASH) and lumbar spine fracture complicated by ureteral injury mimicking spondylodiscitis with osteomyelitis features and retroperitoneal abscess formation followed by the cervical spine fracture. A consecutive analysis and summary of,

J Clin Med. 2023 Nov 5;12(21):6937. doi: 10.3390/jcm12216937.

ABSTRACT

The purpose of this case report is to describe the case of a patient with ankylosing spinal hyperostosis (ASH) and lumbar spine fracture complicated by ureteral injury mimicking spondylodiscitis with osteomyelitis features and retroperitoneal abscess formation followed by the cervical spine fracture. A consecutive analysis and summary of the medical history, radiological documentation, operative procedure, complications, and outcomes were performed. A 59-year-old man presented with abdominal pain three weeks after sustaining a low-energy fall. The performed CT scans demonstrated a three-column fracture at the L3/L4 level and features of ASH. Additionally, MRI scans demonstrated hyperintense fluid collection within L3/L4 intervertebral space communicating with both psoas major muscles, mimicking spondylodiscitis with osteomyelitis features and retroperitoneal abscess formation. An in situ instrumented lumbar fusion at the L2-L3-L5-S1 levels with implantation vertebral body replacement implant at the L3/L4 level was performed. Postoperative CT imaging revealed evidence of post-traumatic right ureteral injury. Following urological treatment covering nephrectomy and ureter ligation, the patient was maintained at a 2-year follow-up. After this period, the patient presented again with tetraparesis after sustaining a low-energy fall. The performed CT scans demonstrated a three-column fracture at the C5/C6 level. The combined anterior and posterior osteosynthesis at the C4-C5-C6-C7 levels was performed. This case report presents the rare clinical constellation regarding the lumbar spine fracture complicated by ureteral injury followed by a cervical spine fracture regarding the same patient. The potential injury of retroperitoneal structures, including the ureter after hyperextensive lumbar spine fracture, should be considered in ASH patients. In this case, one should be aware of the atypical clinical presentation regarding the observed spondylodiscitis- and osteomyelitis-like features.

PMID:37959402 | DOI:10.3390/jcm12216937

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Fracture of the Lumbar Spine Associated with Ureteral Injury Mimicking Spondylodiscitis Followed by Cervical Spine Fracture in Patient with Ankylosing Hyperostosis

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J Clin Med. 2023 Nov 5;12(21):6937. doi: 10.3390/jcm12216937.ABSTRACTThe purpose of this case report is to describe the case of a patient with ankylosing spinal hyperostosis (ASH) and lumbar spine fracture complicated by ureteral injury mimicking spondylodiscitis with osteomyelitis features and retroperitoneal abscess formation followed by the cervical spine fracture. A consecutive analysis and summary of
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