Unique Procedure Saves Spine - Dr Cohen Uses Rare Technique

No Known Risk Factors

Ms. Twaits had no known risk factors for spinal infection. In June, she began feeling pain in her left hip, which radiated down her leg, then into her shin and foot.  She went to her job as a hospital administrator, and had pain both sitting and standing. The next day, she saw an orthopedic surgeon who ordered x-rays, prescribed her mild pain killers and started physical therapy. 

The orthopedic surgeon remained concerned about her pain, ordered an MRI and sent her to a neurosurgeon. By late July, her pain became bilateral – intense low back pain radiating down the back of both legs.  She made an appointment to see Stephen D. Burstein, M.D., F.A.C.S., a partner of Benjamin R. Cohen, M.D., F.A.C.S., in Neurological Surgery, P.C.  She soon developed a fever, and needed to be driven to the appointment because she was incapacitated.

Dr. Burstein was alarmed by Ms. Twait’s condition, and sent her to the emergency room at Winthrop University Hospital.  There, she saw Dr. Cohen, who ordered and reviewed new MRIs and bloodwork, which indicated an infection in addition to advanced degeneration of her lower spine.  He scheduled surgery the next day.

Over the next few weeks, Dr. Cohen worked together with orthopedic spine surgeon Marc Agulnick, M.D., F.A.A.O.S. and reconstructive plastic surgeon Thomas A. Davenport, M.D., F.A.C.S. on a series of three surgeries.  These surgeries collectively, with the assistance of intravenous antibiotics, eradicated the infection, treated the underlying stenosis by decompression of the nerves, and stabilized Ms. Twaits’ spine with the use of permanent implanted instrumentation. 

Unique Procedure Saves Spine

Dr. Cohen and Dr. Agulnick used a creative technique that is rarely used in spinal infection.  To strengthen Ms. Twait’s lower spine, where the infection had partially destroyed a number of vertebrae, they  grafted fibular bone on each side of these vertebrae and pelvis.  This was supported by rigid spinal instrumentation to connect her lumbar spine to the pelvis.  Ms. Twaits was put on a six-week course of intravenous antibiotics.

Recovery has not been easy, but Ms. Twaits went back to work in January, and is still continuing oral antibiotics and physical therapy.  She is now doing “great,” she says, and Dr. Cohen expects a full recovery.  “Dr. Cohen and his colleagues saved my life.”  What is her advice to others? “If you have back pain that is not improving or worsening despite conservative treatments, seek medical attention right away.”