This 50-years old lady had infectious spondylitis at C6/7, with marrow edema and epidural soft tissue, and a pattern that is typical of bacterial, non TB infectious spondylitis. The CT showed end-plate irregularity.

The plan was to enter the disc and scrape the end-plates. Tried first with a right anterolateral approach with an 18G coaxial biopsy gun, but got no material. Because her neck was short, I couldn’t manipulate more, so then decided to use a left trans-thyroid approach. Aspirated blood from the disc and end-plates. The culture was E.coli.