Involvement of the spinal cord has not been reported in osteomyelitis of the spinal column caused by Pseudomonas aeruginosa. Cerebrospinal fluid findings have been reported only once in osteomyelitis of the spine by this agent. Our patient had persistently increased cerebrospinal fluid protein during an acute episode of cervical spine osteomyelitis, characterized by fever and neck pain. Roentgenograms of the cervical spine and neurologic examination did not show any definite abnormality. He became paraplegic 18 months later, after having symptoms of numbness of the feet and progressive weakness of the legs for 1 month. A surgical procedure and antibiotic treatment resulted in remarkable recovery. A bone specimen grew P. aeruginosa.