Pyogenic osteomyelitis of the atlas: a case report.

Abstract

Case report. To document our experience with conservative treatment of vertebral osteomyelitis of the atlas. Although several investigators have reported osteomyelitis in the upper cervical region, most of them included the odontoid process. This is a very rare case of successful conservative treatment of osteomyelitis of the atlas. A 37-year-old man with pyogenic osteomyelitis caused by Streptococcus was treated conservatively. After needle biopsy, the patient underwent a 3-month antibiotic course administrated both intravenously and orally with a cervical orthosis for 4 months. The patient was pain free with no neurologic deficit at the 24-month follow-up, and CT scan showed remodeling of the lesion of the atlas. Conservative treatment of pyogenic osteomyelitis of the atlas with antibiotics and immobilization was shown to be sufficient in this case.