Clinical Analysis of Misdiagnosis and Mistreatment of Spinal Infections
LI Jianhua
YANG Yang
WANG Shuai
CHANG Zhengqi
Abstract：Objective To explore the causes and preventive measures of misdiagnosis and treatment of spinal infection.Methods The clinical data and treatment process of 2 patients with vertebral infection who were misdiagnosed as vertebral compres-sion fracture and underwent verteatoplasty from 2022 to 2024 were retrospectively analyzed.Results A patient was admitted to our hospital due to recurrent chest and back pain after surgery for misdiagnosed thoracic compression fracture which had been treated with vertebroplasty in another hospital.After admission,relevant medical examinations were given,and CT-guided puncture was performed for pathological examination,which confirmed the diagnosis of vertebral infection.Misdiagnosis lasted 14 d.After diagno-sis and improvement of preoperative preparation,pedicle screw fixation across infected segments and lesion clearance with vacuum sealing drainage(VSD)were performed,and the incision healed well.X-ray examination at 6 months after surgery indicated that the infection had been cured.A patient was admitted to our hospital with recurrent low back pain after surgery for misdiagnosed lum-bar compression fracture which had been treated by vertebroplasty in a local hospital.After admission,the relevant medical exami-nation was performed,then percutaneous foraminal endoscopic surgery was performed,and part of the pus was sent for pathological examination to confirm the vertebral infection.The misdiagnosis lasted 4 d.Percutaneous screw fixation across the infected segment was performed,followed by lesion clearance+VSD.Reexamination with magnetic resonance imaging at 1 month after surgery indi-cated that the infection was effectively treated.Conclusion Spinal infection and osteoporotic vertebral compression fracture are similar on imaging and difficult to distinguish.Therefore,the clinician should make a comprehensive judgment according to the pa-tient's condition and examination results,and biopsy should be performed if necessary to clarify the diagnosis and reduce misdiagno-sis and mistreatment.
Keywords：Spinal diseasesInfectionMisdiagnosisOsteoporotic fracturesPathological examinationPedicle screw fixa-tionNegative-pressure wound therapyMagnetic resonance imaging
Publication Date：2025-02-14
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1-5 )