RESUMO
Mycobacterium abscessus (M. abscessus) infections primarily affect immunocompromised patients who commonly present with non-orthopedic infections. We present a case of a 63-year-old female presented with persistent back pain and radicular pain. Computed tomography and magnetic resonance imaging showed a large multiloculated anterior epidural abscess. We show here the unique occurrence of lumbar M. abscessus vertebral osteomyelitis, which was treated with L2 and L3 corpectomies, anterior lumbar interbody fusion, and posterior instrumentation via an anterolateral thoracoabdominal (TA) incision. Vascular surgery provided L1-L4 spine exposure via a left anterolateral TA incision, whereas orthopedic surgery performed L2 and L3 corpectomies with lumbar cage placement and posterior instrumentation in two separate procedures. The patient was discharged to a skilled nursing facility, retaining all neurological function, and is progressing well on follow-up.
RESUMO
This operative video details treatment of a cervical disk herniation through a minimally invasive posterior cervical foraminotomy and microdiskectomy. A man in his 20s presented with unilateral C6-7 radiculopathy, and imaging findings indicated a paracentral disk herniation at C6-7. There was no evidence of spinal cord compression or cervical myelopathy and no severe spondylosis. Therefore, a posterior cervical foraminotomy was offered rather than an anterior diskectomy and fusion or arthroplasty to preserve segmental motion and limit potential implant-related complications. The patient consented to the procedure. This video reviews the nuances of this approach and the key surgical steps to ensure adequate decompression without introducing iatrogenic instability. The patient tolerated the procedure well and reported immediate relief of radicular pain after surgery. He returned to work without activity restrictions at the 2-week mark. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.