Jairus Quesnele1, John Dufton, Paula Stern. 1. Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Canada ; Division of Graduate Studies, Clinical Sciences, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: To present a case of a patient with spinal infection (SI) and highlight the chiropractor's role in the prevention or minimization of devastating complications of SI. BACKGROUND: Recent literature trends suggest an increasing prevalence of SI. Patients with SI most commonly present with unremitting progressive back pain and may or may not have fever or neurological signs. To avoid negative post-infection sequelae, establishing an early diagnosis and treatment is crucial. CLINICAL FEATURES: A 29-year-old female diagnosed with L5-S1 disc herniation with impingement of the right S1 nerve root opted for surgical management. Iatrogenic bowel perforation during her spinal surgery resulted in contamination of the spinal surgical site, and findings in keeping with disco-osteomyelitis with epidural and paraspinal phlegmon formation were visualized on contrast enhanced MRI. CONCLUSION: Recent trends of increased spinal infection urge a heightened awareness by the chiropractor. The chiropractor can provide early diagnosis and supportive multidisciplinary care for such patients.
OBJECTIVE: To present a case of a patient with spinal infection (SI) and highlight the chiropractor's role in the prevention or minimization of devastating complications of SI. BACKGROUND: Recent literature trends suggest an increasing prevalence of SI. Patients with SI most commonly present with unremitting progressive back pain and may or may not have fever or neurological signs. To avoid negative post-infection sequelae, establishing an early diagnosis and treatment is crucial. CLINICAL FEATURES: A 29-year-old female diagnosed with L5-S1 disc herniation with impingement of the right S1 nerve root opted for surgical management. Iatrogenic bowel perforation during her spinal surgery resulted in contamination of the spinal surgical site, and findings in keeping with disco-osteomyelitis with epidural and paraspinal phlegmon formation were visualized on contrast enhanced MRI. CONCLUSION: Recent trends of increased spinal infection urge a heightened awareness by the chiropractor. The chiropractor can provide early diagnosis and supportive multidisciplinary care for such patients.
Entities:
Keywords:
discitis/diskitis; disk space infection; outcome; pyogenic; spinal infection; vertebral osteomyelitis
Authors: Oluwaseun O Falade; Emmanuel S Antonarakis; Daniel R Kaul; Sanjay Saint; Patrick A Murphy Journal: N Engl J Med Date: 2008-08-07 Impact factor: 91.245