Kliman-PCR

If surgeons submitted biopsy specimens from vertebral fusions for Bb PCR we would see a lot more cases. We did this for my wife's L4-L5 fusion, required by grade 3 spondilothesis and severe stenosis causing extreme sciatic and back. We got positive PCRs (plural) for Bb and (thanks to Ginny's help in suggesting it) negatives for several other likely TBDs. The surgeon reported her case as part of a poster session at a national conference. He was both astonished and convinced by the results. It's so easy if the surgeon cooperates. Her's did.

PMID: 15474398
TITLE: Sciatica, disk herniation, and neuroborreliosis. A report of four cases.
AUTHORS: Arnaud Dupeyron, Jehan Lecocq, Benoît Jaulhac, Marie-Eve Isner-Horobeti, Philippe Vautravers, Julien Cohen-Solal, Christelle Sordet, Jean-Louis Kuntz
AFFILIATION: Physical Medicine and Rehabilitation Unit, Strasbourg Teaching Hospitals, Avenue Molière, 67098 Strasbourg cedex, France.
REFERENCE: Joint Bone Spine 2004 Sep 71(5):433-7
We report four cases of sciatica in patients with same-level disk herniation confirmed by computed tomography and a final diagnosis of acute radiculitis caused by Borrelia burgdorferi, with a favorable response to ceftriaxone therapy. The neurological manifestations of Lyme disease are protean, and a potential contribution of concomitant disk disease to sciatica can lead to diagnostic wanderings. Disk lesions and infectious conditions that can cause sciatica are discussed. Whether a favorable response to antibiotic therapy should be taken as proof of B. burgdorferi radiculitis deserves discussion. In practice, in a patient with clinical manifestations suggesting disk-related nerve root pain and residing or having traveled to an endemic area, B. burgdorferi infection should be looked for, as both etiologies can coexist.