title: Pan-spinal infection: a case series and review of the literature.
abstract: BACKGROUND
  Panspinal infection usually presents with fever, back pain, neurological deficit, and in advanced cases multi-organ failure and septic shock. The choice of treatment for panspinal infection is challenging because these patients are usually medically unstable with severe neurological compromise. The objective of this study is to review management and long term outcomes for patients with panspinal infection.
  
  
  METHODS
  A retrospective review of patients with panspinal infection treated in our center over a 5-year period [Jan 2010-Dec 2014] and a review of the current published literatures was undertaken.
  
  
  RESULTS
  We identified 4 patients with panspinal infection. One case was managed medically due to high perioperative risk, whilst the other three were managed surgically whilst on antibiotic therapy. All 3 cases managed surgically improved neurologically and infection subsided, whereas the patient managed medically did not change neurologically and infection subsided.
  
  
  CONCLUSIONS
  Patients with panspinal infection should be treated surgically unless the medical risk of surgery or anaesthesia is prohibitive.
authors.affiliation: Department of Neurosurgery, Alfred Hospital.
authors.forename: Chien Yew
authors.initials: CY
authors.lastname: Kow
authors.affiliation: Department of Neurosurgery, Alfred Hospital.
authors.forename: Patrick
authors.initials: P
authors.lastname: Chan
authors.affiliation: Department of Orthopaedics, Alfred Hospital.
authors.forename: Greg
authors.initials: G
authors.lastname: Etherington
authors.affiliation: Department of Orthopaedics, Alfred Hospital.
authors.forename: Lu
authors.initials: L
authors.lastname: Ton
authors.affiliation: Department of Orthopaedics, Alfred Hospital.
authors.forename: Susan
authors.initials: S
authors.lastname: Liew
authors.affiliation: Infection Prevention and Healthcare Epidemiology Unit, Alfred Hospital; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Allen C
authors.initials: AC
authors.lastname: Cheng
authors.affiliation: Department of Neurosurgery, Alfred Hospital; ; Department of Surgery, Monash University, Melbourne, Australia.
authors.forename: Jeffrey V
authors.initials: JV
authors.lastname: Rosenfeld
keywords: Panspinal infection; discitis; epidural infection; holospinal infection; spinal infection; subdural infection