{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:55:20Z","timestamp":1768287320032,"version":"3.49.0"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2007,12]]},"abstract":"<jats:p>\u2713The authors describe a case of osteomyelitis of the craniocervical junction caused by iatrogenic infection of the spine during corticosteroid injection therapy. This 58-year-old diabetic man presented with acute exacerbation of neck pain that had began 4 months prior to admission. He did not experience the associated fever, chills, or sweats, but he did notice transient weakness in the right upper extremity. A computed tomography (CT) scan of the cervical spine demonstrated a destructive process involving the odontoid and the left occipitocervical and atlantoaxial joints that was not present on a CT obtained 2 months earlier, just before trigger-point and left-sided C1\u20132 facet joint corticosteroid injections. A diagnosis of staphylococcal osteomyelitis was made, and initial treatment with external immobilization and appropriate antibiotic therapy failed to control radiographically demonstrated and clinical progression. The patient was successfully treated using staged anterior decompression and posterior instrumented fusion with prolonged antibiotic therapy.<\/jats:p>\n<jats:p>To the authors' knowledge this case is the first reported instance of iatrogenic pyogenic osteomyelitis of the craniocervical junction successfully treated with anterior decompression and delayed posterior arthrodesis.<\/jats:p>","DOI":"10.3171\/spi-07\/12\/664","type":"journal-article","created":{"date-parts":[[2007,12,13]],"date-time":"2007-12-13T21:37:59Z","timestamp":1197581879000},"page":"664-668","source":"Crossref","is-referenced-by-count":16,"title":["Iatrogenic pyogenic osteomyelitis of C-1 and C-2 treated with transoral decompression and delayed posterior occipitocervical arthrodesis"],"prefix":"10.3171","volume":"7","author":[{"given":"Patrick J.","family":"Reid","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J.","family":"Holman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Methodist Neurological Institute, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0070664","series-title":"J Neurosurg","first-page":"162","article-title":"Osteomyelitis and pathological fracture of the axis. Case illustration","volume":"90","author":"Anton","year":"1999"},{"key":"b2-0070664","series-title":"Pain Physician","first-page":"229","article-title":"A systematic review of therapeutic facet joint interventions in chronic spinal pain","volume":"10","author":"Boswell","year":"2007"},{"key":"b3-0070664","series-title":"Spine","doi-asserted-by":"publisher","first-page":"E369","DOI":"10.1097\/01.brs.0000168375.88129.3a","article-title":"Complete osteolysis of the dens with atlantoaxial luxation caused by infection with Staphylococcus aureus: a case report and review of the literature","volume":"30","author":"Busche","year":"2005"},{"key":"b4-0070664","series-title":"Rev Infect Dis","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1093\/clinids\/9.2.265","article-title":"Update on spinal epidural abscess: 35 cases and review of the literature","volume":"9","author":"Danner","year":"1987"},{"key":"b5-0070664","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"2012","DOI":"10.1056\/NEJMra055111","article-title":"Spinal epidural abscess","volume":"355","author":"Darouiche","year":"2006"},{"key":"b6-0070664","series-title":"Medicine (Baltimore)","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1097\/00005792-199211000-00004","article-title":"Bacterial spinal epidural abscess. Review of 43 cases and literature survey","volume":"71","author":"Darouiche","year":"1992"},{"key":"b7-0070664","series-title":"Spine","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1097\/01.BRS.0000109410.46538.74","article-title":"Treatment of pyogenic vertebral osteomyelitis with anterior debridement and fusion followed by delayed posterior spinal fusion","volume":"29","author":"Dimar","year":"2004"},{"key":"b8-0070664","series-title":"J Pain Symptom Manage","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/0885-3924(94)90156-2","article-title":"Cervical epidural abscess following trigger point injection","volume":"9","author":"Elias","year":"1994"},{"key":"b9-0070664","series-title":"Scand J Infect Dis","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1080\/00365540500372689","article-title":"Spondylodiscitis after facet joint steroid injection: a case report and review of the literature","volume":"38","author":"Falagas","year":"2006"},{"key":"b10-0070664","series-title":"Arthritis Rheum","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1002\/art.1780340113","article-title":"Septic arthritis of the C1\u2013C2 lateral facet joint and torticollis: pseudo-Grisel's syndrome","volume":"34","author":"Halla","year":"1991"},{"key":"b11-0070664","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1056\/NEJM194812022392301","article-title":"Nontuberculous spinal epidural infections","volume":"239","author":"Heusner","year":"1948"},{"key":"b12-0070664","series-title":"Pain Med","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1111\/j.1526-4637.2006.00088.x","article-title":"Discitis after lumbar epidural corticosteroid injection: a case report and analysis of the case report literature","volume":"7","author":"Hooten","year":"2006"},{"key":"b13-0070664","series-title":"Anesth Analg","first-page":"1547","article-title":"Small risk of serious neurologic complications related to lumbar epidural catheter placement in anesthetized patients","volume":"96","author":"Horlocker","year":"2003"},{"key":"b14-0070664","series-title":"Spine","doi-asserted-by":"publisher","first-page":"E7","DOI":"10.1097\/01.BRS.0000106764.40001.84","article-title":"Cervical epidural abscess after epidural steroid injection","volume":"29","author":"Huang","year":"2004"},{"key":"b15-0070664","series-title":"Neurosurgery","first-page":"958","article-title":"Spinal epidural abscess: evaluation of factors influencing outcome","volume":"39","author":"Khanna","year":"1996"},{"key":"b16-0070664","series-title":"J Comput Assist Tomogr","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1097\/00004728-200103000-00003","article-title":"Craniovertebral junction tuberculosis: a review of 29 cases","volume":"25","author":"Krishnan","year":"2001"},{"key":"b17-0070664","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"369","DOI":"10.2106\/00004623-196749020-00017","article-title":"Osteomyelitis of the odontoid process. A case report","volume":"49","author":"Leach","year":"1967"},{"key":"b18-0070664","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1016\/S0090-3019(00)00239-1","article-title":"Diagnostic pitfalls in osteomyelitis of the odontoid process: case report","volume":"53","author":"Noguchi","year":"2000"},{"key":"b19-0070664","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1097\/01.bsd.0000211234.68469.92","article-title":"Septic arthritis of the atlantoaxial joint: case report","volume":"19","author":"Sasaki","year":"2006"},{"key":"b20-0070664","series-title":"J Infect","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1053\/jinf.2002.1013","article-title":"Spinal epidural abscess\u2014experience with 46 patients and evaluation of prognostic factors","volume":"45","author":"Tang","year":"2002"},{"key":"b21-0070664","series-title":"Anesth Analg","first-page":"717","article-title":"Cervical epidural abscess after cervical epidural nerve block with steroids","volume":"72","author":"Waldman","year":"1991"},{"key":"b22-0070664","series-title":"Pain Med","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1111\/j.1526-4637.2006.00089.x","article-title":"Septic facet joint arthritis after a corticosteroid facet injection","volume":"7","author":"Weingarten","year":"2006"},{"key":"b23-0070664","series-title":"Spine","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1097\/00007632-199901150-00008","article-title":"Epidural abscess of the cervical spine with osteomyelitis of the odontoid process","volume":"24","author":"Wiedau-Pazos","year":"1999"},{"key":"b24-0070664","series-title":"Intern Med","doi-asserted-by":"publisher","first-page":"161","DOI":"10.2169\/internalmedicine.37.161","article-title":"Cervical spinal epidural abscess following acupuncture: successful treatment with antibiotics","volume":"37","author":"Yazawa","year":"1998"},{"key":"b25-0070664","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.2106\/00004623-198769070-00016","article-title":"Pyogenic osteomyelitis of the occiput, the atlas, and the axis. A report of five cases","volume":"69","author":"Zigler","year":"1987"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/7\/6\/article-p664.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/7\/6\/article-p664.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/7\/6\/article-p664.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T23:31:35Z","timestamp":1681601495000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/7\/6\/article-p664.xml"}},"subtitle":["Case report"],"short-title":[],"issued":{"date-parts":[[2007,12]]},"references-count":25,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/spi-07\/12\/664","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2007,12]]}}}