Cervical radiculopathy in a 31M (C2756)
31 / M - History of recent numbness of the 2nd and 3rd finger of the left hand of 14 days duration, associated with mild neck pain.
What is the diagnosis?
A 47-year-old male underwent L4-5 posterior lumbar decompression and fusion with instrumentation. At the six-week clinical visit he complains of pain in the region of his wound. On physical exam there is wound erythema but no exudate. Laboratory studies show an erythrocyte sedimentation rate of 78 mm/h (normal up to 20 mm/h) and WBC count of 11,200/mm3 (normal 3,500 to 10,500/mm3). An MRI is perfomed and shows a fluid collection dorsal to the thecal sac. What is the most appropriate next step in management?
CT guided aspiration of the fluid collection and cultures
Surgical debridement followed by delayed closure and retention of instrumentation
Surgical debridement followed by delayed closure and removal of instrumentation
Parenteral Cephalexin for 10 days followed by repeart laboratory studies
Broad spectrum intravenous antibiotics for 6 weeks followed by repeart laboratory studies
sir why not answer 1 CT guided aspiration of the fluid collection and culturespt doesn't has instability or neurology so why surgery before try aspiration culture and IV antibiotics