Heroin use linked to increase in rare spine infection

Doctors identify link between heroin use, rare spine infection

LOUISVILLE, KY (WAVE) - Intravenous drug use is a problem in our community and doctors are learning of another problem it can lead to -- a rare, painful disease that could lead to death.

Physicians at Norton Leatherman Spine are taking a closer look at patients who have a rare spine infection called osteomyelitis.

Doctors are seeing more cases of it and discovered that osteomyelitis can be caused by injecting bacteria along with heroin.

Spine surgeon Dr. Jeffrey Gum, of Norton Leatherman Spine, said osteomyelitis typically starts at the disc level.

“Sometimes if it goes on long enough it spreads to the bones in the spine,” Gum said.

Patients with osteomyelitis are typically elderly, sick diabetics or people with kidney issues. Now, Dr. Gum said they are seeing younger patients.

"Over the past four or five years we've seen that it's mainly coming from patients who are using IV drugs," Gum said.

That could mean drugs like methamphetamine and cocaine, but a lot of times it’s heroin.

“The skin is coated in bacteria most of the time, staph is on our skin, and if a needle has been used it has bacteria in it,” Gum said. “When someone injects, they shower their bloodstream with that bacteria and a lot of times that lands in the spine.”

It’s painful. A lot of times that pain is in the back and can cause weakness in the arms and legs. In extreme cases it can lead to paralysis and death.

Dr. Gum said the heroin epidemic has really changed the patient demographic. In 2012, Norton Leatherman Spine saw only five patients with these serious spine infections, and IV drug use wasn’t a cause of any of them. By 2016, that number had grown to more than 100, with a majority of them coming from patients using intravenous drugs.

“Most of the time when we see those infections, they are a lot farther along,” Gum said. “It means they are more likely that they will end up needing surgery, potentially death and other complications.”

Osteomyelitis can be treated with antibiotics if it’s not that severe. The surgery, Dr. Gum said, is complicated. Norton Leatherman Spine physicians are taking additional steps to protect its patients from the risk of addiction after surgery.

“We realize that the opioid issue in this area is a serious problem, and we are doing everything we can to develop techniques and strategies to help reduce it within spine care,” Gum said.

Those techniques and strategies span from research to innovative robotic technology that assists in spinal surgeries.

Robotic technology increases precision, reduces pain and allows patients to take fewer medications.

In addition to smaller incisions, Gum said efforts by the anesthesia team to develop creative ways to control pain without opioids are producing amazing results that soon will be presented nationally and published in spine literature.

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