Multilevel vertebral osteomyelitis and facet joint infection following epidural catheterisation

Published online: Oct 27 2007

Ranganathan Arun, Shafic Said Al-Nammari, S. M. Hossein Mehdian

From Queen's Medical Centre, Nottingham, United Kingdom, and Leeds General Infirmary, Leeds, United Kingdom


We report a case of multilevel vertebral osteomyelitis with facet joint infection after epidural catheterisation. Back pain relating to regional anaesthetic techniques is common and usually self-limiting. However, it is essential to consider infection in any differential diagnosis. Prolonged use of these regional anaesthetics post-operatively makes the possibility of infection more likely. The microbiology of spine infection resulting from direct spread is not well documented but the few cases reported suggest a wide range of causative organisms. For this reason in cases of spinal infection resulting from epidural catheterisation every effort should be made to obtain a direct tissue sample for pathogen identification and one should not simply rely on blood cultures or non-specific empirical antimicrobials. Delays in commencing appropriate antimicrobials may result in considerable morbidity.