C M Coapes1, G S Roysam. 1. Department of Orthopaedic Surgery, South Tyneside District Hospital, Gateshead. cmcoapes@doctors.org.uk
Abstract
STUDY DESIGN: A case of vertebral osteomyelitis secondary to epidural catheter use is reported. OBJECTIVE: To investigate the occurrence of vertebral osteomyelitis after the use of an epidural catheter. SUMMARY OF BACKGROUND DATA: Vertebral osteomyelitis is a rare but serious complication of epidural catheter use that apparently has not been reported previously in orthopedic literature. METHODS: A patient underwent abdominal surgery, and an epidural catheter was used for postoperative pain relief. He presented 3 months later with severe midlumbar pain. Magnetic resonance imaging and microbiologic examination of a specimen obtained at open biopsy were used in the investigation. RESULTS: Magnetic resonance imaging suggested vertebral osteomyelitis involving L1-L3. The patient underwent open debridement and posterior instrument stabilization. Biopsies taken from L3 pedicles yielded Pseudomonas aeruginosa, which had been recovered earlier from the epidural catheter tip. CONCLUSION: Vertebral osteomyelitis is a rare but serious complication of epidural catheter use.
STUDY DESIGN: A case of vertebral osteomyelitis secondary to epidural catheter use is reported. OBJECTIVE: To investigate the occurrence of vertebral osteomyelitis after the use of an epidural catheter. SUMMARY OF BACKGROUND DATA: Vertebral osteomyelitis is a rare but serious complication of epidural catheter use that apparently has not been reported previously in orthopedic literature. METHODS: A patient underwent abdominal surgery, and an epidural catheter was used for postoperative pain relief. He presented 3 months later with severe midlumbar pain. Magnetic resonance imaging and microbiologic examination of a specimen obtained at open biopsy were used in the investigation. RESULTS: Magnetic resonance imaging suggested vertebral osteomyelitis involving L1-L3. The patient underwent open debridement and posterior instrument stabilization. Biopsies taken from L3 pedicles yielded Pseudomonas aeruginosa, which had been recovered earlier from the epidural catheter tip. CONCLUSION:Vertebral osteomyelitis is a rare but serious complication of epidural catheter use.
Authors: T M Frangen; T Kälicke; M Gottwald; S Andereya; H-J Andress; O J Russe; E J Müller; G Muhr; C Schinkel Journal: Unfallchirurg Date: 2006-09 Impact factor: 1.000