Vertebral osteomyelitis is a rare clinical condition accounting for 1%-7% of all bone-related infections. The increase in chronic diseases such as diabetes mellitus or those that lead to immunosuppression, the increase in spinal instrumentation including epidural catheters for pain management, and the continual increase in intravenous (IV) drug use are factors that have led to the rise in cases. The condition may present subtly without clinical signs and symptoms making early diagnosis difficult. Here, we present a rare case of spontaneous osteodiscitis of the cervical spine complicated by epidural abscess/phlegmon, burst fracture, and spinal cord injury due to methicillin-resistant (MRSA) bacteremia in a patient with a history of intravenous drug use who presented with neck pain. The patient was treated with IV antibiotics and decompressive surgery and, however, was unable to regain the mobility of the lower extremities and regained only slight mobility in the upper extremities leading to an ultimate diagnosis of functional quadriplegia.
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