Description
In this engaging lecture, Matthew Sewell discusses the topic of spinal infections, particularly those not associated with surgical procedures. He begins by offering a light-hearted introduction, referencing the colorful canals of Birmingham, and the unique cultural flavor of the area compared to more picturesque American conference sites, before pivoting to the complexities of spinal infections.
Sewell outlines a methodical framework to approach exam questions regarding spinal infections, emphasizing the importance of history-taking and identifying symptoms such as back pain, fever, and weakness. He highlights common risk factors such as diabetes and drug use, and introduces the diagnostic approach which includes blood tests and MRI scans. MRI is stressed as the gold standard for diagnosing conditions like discitis and vertebral osteomyelitis, revealing the presence of abnormalities in the disk space that may indicate infection.
Throughout his presentation, Sewell balances technical explanations with a conversational tone, inviting audience participation. He discusses case studies, including that of a 30-year-old female returning from Southeast Asia with cough and back pain—her symptoms leading to the suspicion of a serious infection. The discussion covers diagnostic imaging interpretations and treatment options, emphasizing the importance of efficient medical intervention to prevent progression of the condition.
Sewell brings in audience involvement by asking for diagnoses based on images displayed, illustrating the distinctions between tumors and infections in MRI scans. He also delves into specific treatment principles, such as organ-specific antibiotics and surgical interventions for unstable spinal segments due to infection, emphasizing timely action to mitigate neurological damage.
The lecture concludes with a detailed Q&A session, addressing nuanced topics like the management of epidural abscesses and the complexities of treating MDR (multidrug-resistant) tuberculosis, stressing the importance of a multidisciplinary approach in complex cases.
Overall, Sewell succeeds in making a difficult subject accessible and engaging, equipping attendees with practical frameworks and knowledge necessary for tackling spinal infections in clinical and examination settings.