Conservative therapy of atlantoaxial osteomyelitis: A case report

Study Design. A rare case of C1-C2 vertebral osteomyelitis treated conservatively is described. The radiologic findings as well as the follow- up evaluation are reported. Objective. To increase knowledge about the pathogenesis and treatment of vertebral osteomyelitis in the high cervical region. Summary of Background Data. This is one of the first cases reported of successful conservative treatment of osteomyelitis at this level. Methods. In a 58-year-old man with lumber staphylococcal infection, a subsequent cervical infection developed. Because the lumbar spondylitis was treated promptly, the cervical osteomyelitis was treated at a very early stage of development. Results. Operative decompression is the treatment most often used in osteomyelitis at the C1-C2 level. This is an extremely unusual circumstance in which early treatment of the infection negated the need for surgery. Conclusion. Conservative treatment of osteomyelitis at the C1-C2 level can be efficacious in the correct setting.