Micromonas micros: A rare anaerobic cause of late implant failure following spinal surgery

Delayed, postoperative, spine infections are rare, most commonly occurring secondary to fastidious, less virulent pathogens. The etiology may involve a distant infectious focus, not related to the index operation. Patients may present months, or even years postoperatively with pain related to mechan...

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Bibliographic Details
Published in:The journal of spinal cord medicine 2022-03, Vol.45 (2), p.311-315
Main Authors: Sobol, Garret L, Shin, John I, Vives, Michael J, Dever, Lisa L, Harris, Colin B
Format: Article
Language:English
Subjects:
Anaerobiosis
Base Composition
Case Report
Case Reports
Humans
Intervertebral Disc Degeneration
Lumbar Vertebrae - surgery
Male
Middle Aged
Phylogeny
RNA, Ribosomal, 16S
Sequence Analysis, DNA
Spinal Cord Injuries
Spinal Fusion - adverse effects
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Summary:Delayed, postoperative, spine infections are rare, most commonly occurring secondary to fastidious, less virulent pathogens. The etiology may involve a distant infectious focus, not related to the index operation. Patients may present months, or even years postoperatively with pain related to mechanical implant failure, often without additional signs of systemic infection. We present the case of a 59-year-old male who developed rapid disk degeneration and implant failure seven months following instrumented lumbar fusion surgery. The causal organism was found to be Micromonas micros, an anaerobic bacterium typically located in the oral cavity and associated with periodontal disease. The patient was found to have extensive oral caries, which were presumed to have occurred secondary to poor oral hygiene and his use of fentanyl lozenges for chronic back pain. The patient was treated with revision staged spinal surgery and long-term intravenous antibiotics. This case highlights an unusual etiology of delayed postoperative spinal implant failure and provides evidence for periodontal disease as a source of hematogenous seeding in postoperative spinal infections. The orthopaedist should also be aware of the potential relationship between poor oral hygiene and the use of high sugar content fentanyl lozenges in treating chronic back pain in these patients.
ISSN:1079-0268
2045-7723
DOI:10.1080/10790268.2019.1677984