Osteomyelitis is an acute or chronic bone infection, usually caused by bacteria.  Osteomyelitis  is a bone infection often caused by a bacteria called Staphylococcus aureus. Osteomyelitis does not occur more commonly in a particular race or gender. The infection associated with osteomyelitis may be localized or it may spread through the periosteum, cortex, marrow, and cancellous tissue. The bacterial pathogen varies on the basis of the patient’s age and the mechanism of infection. Osteomyelitis affects about two out of every 10,000 people. Osteomyelitis can affect both adults and children. The bacteria or fungus that can cause osteomyelitis, however, differs among age groups. In adults, osteomyelitis often affects the vertebrae and the pelvis. In children, osteomyelitis usually affects the adjacent ends of long bones. Long bones are large, dense bones that provide strength, structure, and mobility. They include the femur and tibia in the legs and the humerus and radius in the arms. Chronic osteomyelitis results when bone tissue dies as a result of the lost blood supply.

Chronic infection can persist intermittently for years. Fever, usually the most obvious sign of an infection, is often absent. Risk factors are recent trauma, diabetes, hemodialysis, and intravenous drug abuse. People who have had their spleen removed are also at higher risk for osteomyelitis.More commonly, chronic osteomyelitis causes bone pain, recurring infections in the soft tissue over the bone, and constant or intermittent drainage of pus through the skin. Osteomyelitis is an infective process which encompasses all of the bone (osseous) components, including the bone marrow. When it is chronic it can lead to bone sclerosis and deformity.  Treatment of osteomyelitis depends on the severity of the infection and whether it is acute (recent) or chronic (has been present for a longer period of time).  Surgery may be needed to drain abscesses or to stabilize affected vertebrae (to prevent the vertebrae from collapsing and thereby damaging nearby nerves or blood vessels).
 
The treatment generally consists of surgical debridement (cleaning) of the infected bony and soft tissue structures, and the prolonged use of antibiotics. Antibiotic therapy is continued for at least 3 weeks after surgery.   Treatment for chronic osteomyelitis may require several operations to remove all the infected bone and other tissue, completely draining the abscess and repairing the bone when possible. Bracing is recommended to provide stability for the spine while the infection is healing. It is usually continued for 6 to 12 weeks, until either a bony fusion is seen on x-ray, or until the patient’s pain subsides. Treatment with free ciprofloxacin or vancomycin for 14 days was ineffective in eradicating osteomyelitis. Surgical decompression is necessary if an epidural abscess places pressure on the neural elements. The goal of surgical treatment is to convert an infection with dead bone to a situation with well-vascularized tissues that are readily penetrated by blood-borne antibiotics.

Osteomyelitis  Treatment Tips

1. Antibiotic therapy is continued for at least 3 weeks after surgery.

2. Bracing is recommended to provide stability for the spine while the infection is healing. It is usually continued for 6 to 12 weeks.

3. Treatment with free ciprofloxacin or vancomycin for 14 days was ineffective in eradicating osteomyelitis.

4. Surgical decompression is necessary if an epidural abscess places pressure on the neural elements.