Adjacent level spondylodiscitis in a patient with thoracic spondylodiscitis: A case report and review of the literature

Introduction. - Adjacent level spondylodiscitis (ALS) after primary surgery for thoracic spondylodiscitis is a very rare condition. Case report. - We report the case of a 76-year-old man with this pathology. A first posterior minimally invasive approach combined with anterior approach to the thoracic spine was safely performed for thoracic spondylodiscitis. More than a year later, exploration of recurrent symptoms with (18)FDG PET scan helped to diagnose ALS. Further surgery was performed. At 3-year follow-up examination showed no recurrence of the infection. Discussion. - ALS should be suspected during recurrent symptoms after spinal fusion surgery. Evaluation should be based on the results of (18)FDG PET scan and surgery. Conclusion. - Bacterial and histopathological analyses combined with an increase of spine fixation and adapted antimicrobial therapy are a safe management for ALS. (C) 2017 Elsevier Masson SAS. All rights reserved.