{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T16:46:49Z","timestamp":1777049209384,"version":"3.51.4"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["114-2314-B-006-051"],"award-info":[{"award-number":["114-2314-B-006-051"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Infectious spondylodiscitis can cause progressive vertebral destruction and instability even after infection control, and some patients decline or are unsuitable for surgery. We report a 67-yr-old man with poorly controlled type 2 diabetes mellitus and hypertension who developed Escherichia coli bacteremia and subsequent infectious spondylodiscitis. Four months after treatment of a traumatic open tibial wound with debridement and split-thickness skin grafting, he presented with progressive low back pain, intermittent fever, and systemic illness with acute kidney injury and hepatic dysfunction. A distal common bile duct stone was treated endoscopically, but fever persisted. A gallium-67 scan raised suspicion for L2-L3 involvement, and LS MRI demonstrated L2-L3 infectious spondylodiscitis with extensive paraspinal and epidural inflammatory changes and bilateral psoas abscesses. CT-guided aspiration and bone biopsy were culture-negative. He improved clinically after approximately 5\u00a0wk of antimicrobial therapy and declined operative debridement or stabilization. One week after completing antibiotics, denosumab (60\u00a0mg, s.c.) was administered. Given that denosumab is not a guideline-supported therapy for infectious spondylodiscitis, it was used off-label as a speculative adjunct to suppress inflammation-associated bone resorption; a second dose was given 6\u00a0mo later. Back pain and function improved with bracing, and serial radiographs showed new bone formation along the superior endplate of L3 with progressive remodeling. At 6-yr follow-up, the patient remained free of adverse effects and demonstrated spontaneous fusion of L2 and L3 with sustained symptom relief. This report is descriptive and hypothesis-generating. The observed remodeling may also reflect expected post-infectious healing under conservative management. Nevertheless, the course raises a testable hypothesis that carefully timed antiresorptive therapy after confirmed infection control may support structural recovery in selected nonoperative patients with marked infection-related vertebral osteolysis.<\/jats:p>","DOI":"10.1093\/jbmrpl\/ziag040","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T16:43:50Z","timestamp":1773333830000},"source":"Crossref","is-referenced-by-count":0,"title":["Vertebral remodeling with denosumab after infection control in\n                    <i>Escherichia coli<\/i>\n                    spondylodiscitis: case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4893-8346","authenticated-orcid":false,"given":"Bing-Hao","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Education Center, National Cheng Kung University Hospital , Tainan 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