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  • Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    You are in uncharted territory for me regarding inadequate treatment for a post-operative spine infection. An abscess (pus in the spine) is possible but most patients with an abscess are “sick” (fevers, chills, advancing neurological deterioration, increased spine pain). Increasing ESR and CRP are an indication of inadequate treatment and advancing infection.

    Generally, with adequate treatment, surgery is not commonly performed but in your case, I cannot determine how you are fairing. A new MRI would be helpful and to compare to the previous MRI for advancement of the infection. You still don’t even know the organism we are treating or if the antibiotic is appropriate.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Sailormoon
    Participant
    Post count: 29

    Hi Dr Corenman,

    Just like you told before, my blood culture came out negative.
    After additional 7days antibiotics IV here is the result compared to a week ago:

    ESR decrease from 54 to 38
    CRP decrease from 9.3 to 4.9

    It means the ceftriaxone works for me. But ESR still high, what does it means?
    Next tuesday i will req for MRI. Regarding pain, until now i still took anti inflammatory so i cant tell.

    Regarding nerve deterioration, could it possibly because of scarring due to infection?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    This is better news. Generally, successful treatment is considered when ESR and CRP drop by 50% which is close to where you are. I would pressure your treating physician to continue IV antibiotics for another week (or 2 would be even better). ESR is improving but not yet at 50% improvement.

    Nerve symptom advancement could be from scarring.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Sailormoon
    Participant
    Post count: 29

    Dr Corenman,

    Scarring should be grow slowly, right?

    I feel worry much regarding nerve deterioration. Almost area of L5-S1 now had deterioration on skin sensory. And pin and needles at my soles becomes stronger.

    Looking at blood check result that showing better result, should be the nerve deterioration at least not progressing.

    Other than discitis, what else causing gradual on set of cauda equina? MRI would be done next Tuesday, i feel so nervous until then.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Infection can cause delayed scarring to the nerve roots which can increase symptoms. I don’t think your symptoms are equivalent to Cauda Equina Syndrome.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Sailormoon
    Participant
    Post count: 29

    Hi Dr Corenman,

    My MRI showing advancement of infection in nerve root and there is large abscess on invertebrae.

    My doctor suggest me to have an operation again to clean the pus and abscess and then continued with fusion.

    I still feel advancement on nerve deterioration because pin and needle getting stronger, deterioration sensory skin keep happening. Saddle anaesthesia on my right getting worst.

    What do you think, Doc to have another surgery 3 times in a row?
    Could fusion been done exactly together with draining the pus and abscess?

    What is the worst scenario that could happen after surgery? Any other things that i should put attention on?

Viewing 6 posts - 31 through 36 (of 56 total)
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