%0 Journal Article
%T A Chronic Post-Surgical Infectious Lumbar Fistula Providing Protection against Imminent Morbidity: A Case Report and Literature Review
%A Jacob L. Van Orman
%A Paul E. Kaloostian
%A Mojdeh Najle-Rahim
%A Joseph L. Vanderlinden
%A Samer S. Ghostine
%J Open Journal of Modern Neurosurgery
%P 41-48
%@ 2163-0585
%D 2017
%I Scientific Research Publishing
%R 10.4236/ojmn.2017.73005
%X Vertebral osteomyelitis (VOM) and spinal epidural
abscesses (SEA) are rare infections on the spinal column, more prominently seen
in intravenous drug users, diabetics and the immunosuppressed. We report an
extremely rare case of a patient with a chronic history of lumbar post-surgical <span style=\"font-family:;\" \"=\"\"><span style=\"font-family:Verdana;\">cutaneo-spinal fistulous infection that was
unresponsive to conventional antibiotic therapy and </span><span style=\"font-family:Verdana;\">ultimately required surgical debridement and spinal re-instrumentation.
The novelty of this case was the chronic nature of the patient¡¯s condition that
was made possible only by a fortunate post-surgical </span><span style=\"font-family:Verdana;\">cutaneo-spinal
fistula that withdrew infected particles away from the neurological structures
and thus prevented imminent compressive and neurological deficits, and possible</span> <span><span style=\"font-family:Verdana;\">eventual
death. This rare case highlights the need for prompt surgical evaluation and
intervention in patients with progressive VOM or SEA with associated</span><span style=\"color:red;\"> </span></span><span style=\"font-family:Verdana;\">cutaneo-spinal fistulas, especially in cases where
conventional antibiotic treatments have failed. We highly recommend a low threshold
for surgical debridement and hardware removal with re-instrumentation as
appropriate before a spinal compressive emergency arises and/or sepsis
develops.</span></span>
%K Spinal Epidural Abscess
%K Vertebral Osteomyelitis
%K Cutaneo-Spinal Fistula
%K Spinal Reconstruction
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=77114