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Spinal Infections in the Elderly Manoj Krishna Spine Surgeon www.spinalsurgeon.com.

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Presentation on theme: "Spinal Infections in the Elderly Manoj Krishna Spine Surgeon www.spinalsurgeon.com."— Presentation transcript:

1 Spinal Infections in the Elderly Manoj Krishna Spine Surgeon

2 Case 1 94 year old Increasing back pain for 6 weeks Dental filling 6 weeks ago No fever/Night Sweats/Loss of weight Some loss of appetite but feels well Pain is severe- unable to walk – in a wheelchair No local tenderness- but points to lumbo-sacral spine No neuro-deficit Unsteady gait with poor balance

3 Case 1 Has a high signal in L34 on the T2 MRI scan, and low signal on T1. Indicates fluid in the disc- most likely an infection In addition has severe spinal stenosis at L34 and L45 – as seen on the cross section. Fluid in Disc Severe Stenosis

4 Case ESR=34, CRP= 30. Not Diabetic Lives alone Treated with disc biopsy and antibiotics for 3 months Moved to care home after discharge

5 Learning points The only clue this was an infection was the loss of appetite- otherwise presented like a degenerative problem Raised ESR and CRP are a strong indicator of an infection- do the tests early on MRI is essential to an early diagnosis- otherwise could have been fatal Most spinal infections now present without a fever Loss of appetite or feeling unwell are early clues

6 Learning points Suspect infection when severe back pain present in the following: The Elderly Diabetics Rheumatoid arthritis On steroids While recovering from a urinary or chest infection


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