Undiagnosed Infection Leads to Paralysis

ByJoseph O'Neill

Updated on

Undiagnosed Infection Leads to Paralysis

Case Overview

This case takes place in Missouri and involves a female patient who underwent fusion surgery on her upper spine. The patient was discharged but later returned to the ER with signs of sepsis from the surgical site, and was consequently was admitted to the ICU. A scan of the upper spine did not reveal evidence of an infection or any other damage to the spine. However, it did not rule out damage at another level of the spine, and did not explain the patient’s symptoms. Some time after initial presentation, the patient developed numbness in her lower extremities. The treating surgeon was notified but did not order any emergency investigations or imaging. Later that day, another scan of the upper spine was ordered as a non-emergency. Upon review of the upper spine, there were no signs of any abscesses. Some time later, another scan of the lower spine was conducted which revealed an infection and several other issues. The patient was taken to the OR for immediate surgical treatment. The remainder of the patient’s admission was difficult, and she never regained motor function in her legs.

Questions to the Orthopedic Surgery expert and their responses

Q1

Do you have experience treating spinal cord compression, resulting from infection? If so, how often?

I treat patients with spinal infections, epidural abscess and spinal cord injuries. In a given year, I estimate that I have to decompress the spinal cord for an infection between 10-30 times. I estimate that I treat 2-3x that many patients/year with spinal infections, but most do not require surgery.

Q2

Should an MRI of the entire spine have been ordered when the patient initially presented?

With the clinical scenario presented to me, I would have ordered a cervical MRI especially with a draining surgical wound. If the cervical MRI was negative for infection, and another obvious source of infection had not been determined for the patient's symptoms, I would have ordered a thoracic/lumbar MRI.

About the expert

This board certified expert has been practicing for nearly a decade. Fellowship trained in Spine Surgery, this orthopedic surgeon is a member of a multitude of prestigious scientific societies. Widely published, he is reviewer for The Spine Journal, Clinical Orthopedic Related Research, and the Journal of Bone and Joint Surgery, and he has delivered more than 45 presentations at national and international scientific meetings. This expert currently serves as an Assistant Professor in the Departments of Neurological Surgery and Orthopaedic Surgery at a major medical university.

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About the author

Joseph O'Neill

Joseph O'Neill

Joe is a seasoned expert in online journalism and technical writing, with a wealth of experience covering a diverse range of legal topics. His areas of expertise include personal injury, medical malpractice, mass torts, consumer litigation, and commercial litigation. During his nearly six years at Expert Institute, Joe honed his skills and knowledge, culminating in his role as Director of Marketing. He developed a deep understanding of the intricacies of expert witness testimony and its implications in various legal contexts. His contributions significantly enhanced the company's marketing strategies and visibility within the legal community. Joe's extensive background in legal topics makes him a valuable resource for understanding the complexities of expert witness involvement in litigation. He is a graduate of Dickinson College.

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