Presented at the 2012 AAPM Annual Meeting « Back

Spondylodiscitis and Epidural Abscess After Stem Cell Injections to the Spine for Chronic Back Pain: A Case Report

Hamilton Chen, MD, hchen82@gmail.com¹, Eaton Lin, MD², Steven English, MD¹, Patricia Nance, MD³, (1) UCI Medical Center, Orange, California, (2) St. Lukes-Roosevelt Hospital, New York, New York, (3) Long Beach VA Medical Center, Long Beach, California

Introduction/Statement of the Problem: A 59-year-old male presented to a tertiary care center with a 2-month history of worsening lower back pain. Two months prior to presentation, the patient had gone to Mexico and received multiple stem cell injections from donor placenta into the lumbar intervertebral disc at multiple levels. Since these injections, his back pain had progressively worsened. An MRI was performed and revealed L3-L5 epidural/paravertebral abscess with discitis and osteomyelitis. Results: Bone biopsy results were positive for candida parapsilosis and negative for bacteria. The patient was started on vancomycin, cefipime and fluconazole. An L2-L5 laminectomy and I&D were performed by neurosurgery. Following surgery, the patient was transferred to a rehabilitation unit. He remained on antibiotics and antifungals for 6 weeks. Repeat MRI showed improvement in epidural abscess, discitis and osteomyelitis. Antimicrobials were discontinued and the patient was discharged home. Follow-up gadolineum scan 3 months after discharge verified infection resolution. Conclusion: Stem cell injections have been available for purchase in the global health marketplace in recent years.1 Mexico has a flourishing stem cell industry, utilizing donor placenta as a source for stem cells to treat a variety of ailments, such as chronic discogenic pain, cerebral palsy, autism, and paralysis.2,3 Even though stem cells may be a promising treatment modality, this patient's presentation demonstrates the catastrophic complications that can result from stem cell injections and that medical tourism for the procedure should be considered high risk. References: 1)Turner L., "Medical tourism, and the global marketplace in health services: US patients, international hospitals, and the search for affordable health care." Int J Health Serv. 2010;40(3):443-67. 2)Ho, J., "Stem Cell Research Policies around the World." Yale J Biol Med. 2009 September; 82(3): 113–115. 3)Zarembo A. "A desperate injection of stem cells and hope." Los Angeles Times [Internet] 2005. Feb 20, [cited 2011 Aug 15]. Available from: http://www.latimes.com/features/health/medicine/la-sci-stemcells20feb20,1,4516556.story.

Funding: None