Vertebral osteomyelitis secondary to epidural catheter use: a case report.
METHODS
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.


BACKGROUND
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.


CONCLUSIONS
Vertebral osteomyelitis is a rare but serious complication of epidural catheter use.
Coapes
C M
CM
Department of Orthopaedic Surgery, South Tyneside District Hospital, Gateshead. cmcoapes@doctors.org.uk
Roysam
G S
GS
D000208:Acute Disease; D015360:Analgesia, Epidural / Q000009:adverse effects*; D002404:Catheterization / Q000009:adverse effects*; D015299:Discitis / Q000209:etiology*; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology* / Q000473:pathology; D010149:Postoperative Pain / Q000517:prevention & control