Paraplegic with osteomyelitis

[jaylav56]

Hello everyone
this is my first time on ispine forum, I hope someone can give me an answer or opinion.
My brother is a 50 year old T11 complete paraplegic, 5 years post injury, after experiencing leg cramps and lower back main for several months he went to an Orthopedic Dr. who ordered an MRI, the results showed that he had Osteomye litis in his spine and that it had completely destroyed his L5 vertebrae. Because he is paralyzed he could not feel the pain that a non-paraplegic would feel, the infection control Dr's and the Neuro Surgeon decided the best plan of treatment was to do a needle biopsy, culture it and treat with IV antibiotics for 8 weeks, incidentally the culture came back negative, but, going with the MRI results and an elevated CRP and Sed.rate results we did 8 weeks of IV antibiotics using a broad spectrum antibiotic. on friday the last day of treatment another MRI was done it showed the Osteomyelitis has spread to his L3, L4 and S1 vertebrae, he has had no symptoms no fever chills or anything, his White blood cell count is normal and even though his CRP and sed.rate levels are elevated they are not through the roof. The Neuro surgeon still does not want to operate because eventhough the MRI looks bad he feels at this point surgery is too much of a risk. we are in the Orlando area and would like to know if anyone else has had this diagnosis and can recommend someplace where we can go for a second opinion. We will appreciate any help we can get, Thank you all.

[mmglobal]

Jay, I'm so sorry that your brother finds himself in this situation. I have only had one client with osteomyelitis (infection of the bone). Actually, it started as discitis (infection of the disc) that spread to adjacent vertebrae. He was told that IV antibiotics alone would not resolve the infection. A debridement surgery in which they physcally removed accessible infected tissues and bathed the area with antibiotics. This was followed with a long course of IV antibiotics via PICC line.

Strangely, he was evaluated for discitis, but the infection parameters (SED rate, CRP, etc...) were too low to make the diagnosis. This allowed the infection to rage much longer before treatment was started. This was a VERY painful condition... so severe that the patient could not ambulate. Following treatment, his recovery (pain wise) was quite slow, but after more than a year, he started to return to normal.

I don't know how this case relates to your brother. They are not just controlling the normal infection parameters... I would have thought the biopsy would have been dispositive.

I wish I could offer you something more. Good luck to you and your brother!

Mark

[jaylav56]

Thank you for your response, The Infection control Dr.'s came and they've decided to do another needle biopsy and send samples to the pathology department as well as microbiology, so we're praying that it identifies the bacteria or whatever is causing the infection so it can be treated.
I think because the other patient was not paralyzed he was able to feel the pain symptoms associated with osteomyelitis whereas my brother could not. Thank you again for taking the time to respond

[Maria]

I too am sorry to read what's going on with your brother and I hope that a more specific antibiotic might work once the bacteria has been identified. Please keep us posted as to what works for your brother and I will be adding good thoughts for him with knocking this out ASAP! Maria

[jsewell]

jaylav56 i am sorry this is happening to your brother, he has enough to deal with without an infection. I am afraid i have no suggestions. I have had a lot of surgeries, i need to update my list, but fortunately no infections. I will pray for both of you and thank you for being such a good brother to him.
Judy