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Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
Serious complication 1 year after sacrospinous ligament fixation
Violet J Faber1, Huub C van der Vaart, Ben G F Heggelman
1Department of Obstetrics and Gynecology, Meander Medical Centre, Ringweg Randenbroek 110, Amersfoort, The Netherlands. vjfaber@gmail.com
Summary
Group A Streptococcus caused gluteal myositis one year after sacrospinous ligament fixation. Vaginal atrophy and non-resorbable sutures likely facilitated the infection, which was successfully treated with antibiotics and local estrogens.
Area of Science:
- Gynecologic surgery
- Infectious disease
Background:
- Sacrospinous ligament fixation is a surgical procedure used to treat pelvic organ prolapse.
- Non-resorbable sutures are often used in gynecologic procedures, posing a potential risk for long-term complications.
Observation:
- A patient developed gluteal myositis, an inflammation of the gluteal muscles.
- The myositis was caused by a Group A Streptococcus infection.
- The onset of infection occurred one year following sacrospinous ligament fixation surgery.
Findings:
- The infection likely spread from the vaginal vault to the gluteal region.
- Vaginal atrophy may have created a pathway for infection through the non-resorbable sutures.
- The patient's gluteal myositis was successfully treated with intravenous antibiotics and local estrogen therapy.
Implications:
- This case highlights a rare but serious complication of sacrospinous ligament fixation.
- Vaginal atrophy should be considered a risk factor for suture-related infections after pelvic surgery.
- Prompt diagnosis and combined antibiotic and estrogen therapy can effectively manage such infections.
