In two patients with total paralysis caused by hematogenous pyogenic osteomyelitis the diagnosis was missed initially and both were incorrectly diagnosed as having tuberculous spondylitis. In each instance laminectomy had not resulted in any improvement.
Adequate treatment of hematogenous pyogenic osteomyelitis of the spine complicated by spinal paralysis depends on early diagnosis and a thorough understanding of the pathological process involved. Paraplegia complicating vertebral infection may be reversible provided proper treatment is not delayed. Costotransversectomy and lateral rachitomy offer direct access to the diseased area anterior to the dura and ensure that pressure on the spinal cord is relieved.