Attending Version: Back Pain Emergencies Module; created by Dr. Wendy Gerstein

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V. Treatment:
A. Vascular – require emergent surgical consults. AAA rupture 30 day survival rate 11% in some series. While waiting for consult, control hypertension (beta blocker + vasodilator) if present.

B. Spinal cord compression (due to malignancy, infection such as epidural abscess, herniated disc/cauda equina syndrome, hematoma): emergent diagnostic imaging – MRI or CT with myelogram, emergent orthopedic or neurosurgical consult, add IV steroids if due to malignancy, antibiotics if infectious.

C. Osteomyelitis without any neurologic deficits – blood cultures/esr/crp/cbc, MRI, arrange biopsy, hold antibiotics only if clinically stable until after biopsy, then start empiric coverage based on risk factors for particular pathogens.

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