Doctors treat chronic osteomyelitis with surgery and antibiotics. In acute osteomyelitis in children or vertebral osteomyelitis, surgery isn't always necessary.
What type of surgery you undergo for osteomyelitis depends on what bone is infected. Surgery may include one or more of the following procedures:
• Drain the infected area. Opening up the area around your infected bone allows your surgeon to drain any pus or fluid that has accumulated in response to the infection.
• Remove diseased bone and tissue. In a procedure called debridement, the surgeon removes as much of the diseased bone as possible, taking a small margin of healthy bone to ensure that all the infected areas have been removed. Surrounding tissue that shows signs of infection also may be removed.
• Restore blood flow to the bone. Your surgeon may fill any empty space left by the debridement procedure with a piece of bone or other tissue, such as skin or muscle, from another part of your body. Sometimes temporary fillers are placed in the pocket until you're healthy enough to undergo a bone graft or tissue graft. The graft helps your body repair damaged blood vessels and form new bone.
• Remove any foreign objects. In some cases, foreign objects, such as surgical plates or screws placed during a previous surgery, may need to be removed.
In order to stabilize the affected bone and the new graft, you may need to have metal plates, rods or screws inserted into the bone. This procedure is sometimes performed later. Your doctor may use other devices to stabilize your affected bone, such as external fixators.
People who can't tolerate surgery
Surgery as an osteomyelitis treatment isn't available to everyone. People who are very ill may not be able to endure the extensive surgery and recovery. In these cases, doctors may use antibiotics for longer periods of time, sometimes for years, in an attempt to suppress the infection, though cure generally isn't possible with this approach. If the infection persists, amputation of all or part of an infected arm or leg may be necessary.
If your doctor suspects you have chronic osteomyelitis, he or she works to determine exactly what microorganism is causing the infection before prescribing antibiotics. Your doctor uses a bone biopsy or a piece of bone removed during surgical treatment to determine what's causing the infection.
Once the bacterium or fungus causing your infection has been identified and you've undergone surgery, if necessary, your doctor selects the antibiotic most likely to be effective in fighting your particular type of infection. Antibiotics are administered most often through a vein in your arm (intravenously) or, in some cases, they can be taken orally. You typically take antibiotics for four to six weeks, or even longer. In some cases, you may need to take antibiotics for the rest of your life.
Antibiotics carry a risk of side effects, including nausea, vomiting and diarrhea. Allergic reactions also can occur. Talk to your doctor about the side effects to expect from your specific medication.