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History:
Lumbar Spine Infection Diagnosis is essential in identifying the root cause of chronic lower back issues. A 33-year-old woman visited Spine Infection Treatment Doctor in Pune, Dr. Sangram Rajale, with a three-year history of persistent low back pain. Over the last month, she developed pain in her right leg, further worsening her discomfort. Her condition significantly declined in recent months, causing intense pain and disability.
The pain intensified during everyday movements like rising from a sitting position, walking, and turning in bed. Eventually, she became bedridden and unable to manage daily activities, including caring for her two small children—the youngest being only two years old.
This severe loss of independence affected not only her physical but also her emotional well-being. She experienced deep psychological distress due to her limited ability to fulfill her responsibilities as a mother and spouse. Upon examination, doctors noted a visible deformity in her lower back, which severely impacted her mobility and quality of life.
Prompt and accurate Lumbar Spine Infection Diagnosis played a key role in addressing her condition and planning effective treatment.
ON EXAMINATION OF LS SPINE :-
The patient’s walking posture revealed a forward stoop with a noticeable kyphotic (hunched) back. She was unable to walk on her heels or toes due to pain, and her overall mobility had significantly declined. Fatigue set in after walking just a few steps, forcing her to sit down frequently. She also experienced pain during forward bending (flexion) and had restricted, painful backward bending (extension) in her lower back.
A detailed physical examination further highlighted a kyphotic deformity in the lower spine. Although sensations in both lower limbs remained intact, her functional limitations were severe.
In such complex cases, accurate Lumbar Spine Infection Diagnosis is essential for identifying the underlying cause of pain and disability. Timely Lumbar Spine Infection Diagnosis not only helps in tailoring the treatment plan but also prevents further deterioration. Comprehensive care based on proper Lumbar Spine Infection Diagnosis leads to better recovery and restored mobility.
MRI:
The MRI findings suggested a complex pathology involving vertebral destruction, soft tissue edema, intradiscal infection, psoas abscess, bone destruction, and deformity. These findings aligned with the patient’s clinical presentation of severe chronic low back pain, radicular pain, mobility issues, and deformity, indicating a serious infective process or Koch’s spine (tuberculosis of the spine) as a possible diagnosis.
Destruction and Collapse at L4-5 Level with Marrow Edema:
This correlated with the patient’s chronic low back pain, as destruction and collapse of the vertebral segment could cause instability and pain in the lower back region.
Pre-Paravertebral and Epidural Soft Tissue Edema:
The presence of edema in these areas indicated inflammation and swelling around the spine, contributing to pain and potentially compressing nearby nerves, leading to radicular pain (pain radiating down the right lower limb).
Intradiscal Infection and Large Psoas Abscess:
These findings suggested an infective process affecting the intervertebral disc and adjacent soft tissues. Infection in this area could cause severe pain, especially with movements like getting up from a sitting position and walking.
Bone Destruction at L4 and L5 with Epidural Collection:
Bone destruction and epidural collection were indicative of severe pathology, likely contributing to the patient’s increased pain, disability, and difficulty walking. The destruction of vertebral bodies could lead to instability and deformity, as noted in the MRI report.
Enlargement and Kyphotic Deformity at S1-2 Vertebrae:
Kyphotic deformity in this area, along with massive bone destruction, were likely contributing to the patient’s difficulty in walking and the observed deformity on physical examination.
Operation:
The surgery that was performed on 1/11/2023 was a D12-S2AI fixation, which involved debrement, fusion, deformity correction, and bone graft filling in the bone void. Additionally, a pus culture and biopsy were sent during the procedure. Surgery was performed by Dr Sangram Rajale. The surgery was likely performed to address the complex spinal issues observed in the patient, as indicated by the MRI findings and clinical history. Here’s a breakdown of why each aspect of the surgery may have been necessary:
D12-S2AI Fixation:
This referred to spinal fixation from the 12th thoracic vertebra (D12) to the 2nd sacral vertebra (S2AI). Fixation involved stabilizing the spine using screws and rods to prevent further movement and deformity.
Debridement:
Debridement involved the removal of infected or damaged tissue, which was have been necessary to address the intradiscal infection, psoas abscess, and bone destruction observed in the MRI.
Fusion:
Fusion was the process of joining two or more vertebrae together using bone grafts or implants. It was performed to stabilize the spine and promote healing after debridement and correction of deformities.
Deformity Correction:
This aspect of the surgery likely involved realigning the spine to correct any kyphotic deformity observed, improving the patient’s posture and reducing pain.
Bone graft was used to fill bone voids created during debridement and due to bone destruction. It promoted bone healing and fusion between vertebral segments.
Pus Culture and Biopsy:
Sending pus culture and biopsy samples helped identify the specific infective organism causing the spinal infection, guiding targeted antibiotic therapy. Overall, the surgery aimed to address the patient’s severe spinal pathology, including infection, deformity, instability, and bone destruction. The implants used, such as polyaxial screws and connecting rods, were essential for stabilizing the spine and supporting the fusion process, ultimately improving the patient’s mobility and quality of life.
Condition On Discharge:
The successful surgical intervention not only addressed the patient’s physical ailments but also had far-reaching positive effects on her mental health and overall quality of life, allowing her to regain independence, mobility, and a sense of well-being. After undergoing surgery, the patient experienced significant improvements in various aspects of her health and well-being. Here’s is how the surgery positively impacted her:
Improved Mobility::
Following the surgery, the patient was able to ambulate, restoring her ability to walk and move around independently. This improvement in mobility had greatly enhanced her daily activities and quality of life.
Pain Relief:
The surgery also led to a reduction in the patient’s pain levels, she experienced relief from the chronic low back pain and radicular that had been troubling her for years.
Deformity Correction:
The corrective measures taken during surgery successfully addressed the kyphotic deformity observed in her lower back. This correction not only improved her physical appearance but also contributed to better posture, reduced strain on her spine, and alleviated associated discomfort.
Resolution of Infection:
Over the course of a year or so post-surgery, the patient was completely free of the infection that had necessitated the surgery initially. This indicates successful management of the infective process, likely through the combination of surgical intervention, appropriate antibiotic therapy, and post-operative care.
Positive Impact on Mental Health:
The overall improvement in her physical health, reduction in pain, correction of deformity, and resolution of infection had a significant positive impact on the patient’s mental health. Relief from chronic pain and physical limitations often leads to improved mood, reduced anxiety, and enhanced overall mental well-being.
Enhanced Quality of Life:
Collectively, these positive outcomes resulting from the surgery would have greatly enhanced the patient’s overall quality of life. She would have been able to engage more fully in daily activities, enjoy improved mobility and comfort, and experience a better sense of physical and emotional well-being.