Related Experiment Video
Updated: Feb 3, 2026
A Mouse Model of Lumbar Spine Instability
Published on: April 23, 2021
Necrotizing Fasciitis Involving Spine: Unusual Medical Emergency for Spine Surgeon
Alisson R Teles1, Spencer Montgomery2, Kenneth C Thomas2
1McGill Scoliosis & Spine Group, McGill University, Montreal, Quebec.
Background:
Necrotizing fasciitis (NF) is a surgical diagnosis characterized by a rapidly progressive soft tissue infection, widespread tissue necrosis, and associated systemic illness. Friability of the superficial fascia, dishwater-gray exudate, and absence of pus are surgical characteristics of this diagnosis. Due to rapid progression of the infection, early recognition and aggressive surgical debridement are crucial to reduce mortality. Despite being commonly seen by general, plastic, and orthopedic surgeons, NF is an extremely rare spine surgery emergency. Our objective is to report on a case of NF involving the spine and highlight this unusual surgical emergency for the spine surgeon.
Case Description:
We present a rare case of a 61-year-old woman who presented to the emergency department in septic shock. She had a 1-week history of increasing back pain before presenting to us. Computed tomography revealed extensive soft tissue emphysema with involvement of the L3 vertebral body and spina canal. She underwent emergency surgical debridement. Despite maximal medical and surgical therapies, the patient died secondary to multisystem organ failure within 36 hours of initial presentation.
Conclusions:
To the best of our knowledge, the literature presents only 1 previous case reported involving the spine. Necrotizing fasciitis is an unusual surgical spine surgery emergency. Spine surgeons should be aware of this diagnosis in order to provide timely aggressive surgical debridement.
Insights
Necrotizing fasciitis (NF), a severe soft tissue infection, is a rare surgical emergency in spine surgery. Early recognition and aggressive debridement are critical for patient survival.
Area of Science:
- Spine Surgery
- Infectious Disease
- Surgical Pathology
Background:
- Necrotizing fasciitis (NF) is a rapidly progressive soft tissue infection with high mortality.
- Characterized by tissue necrosis and systemic illness, NF requires prompt surgical intervention.
- While common in other surgical fields, NF is exceptionally rare in spine surgery.
Observation:
- A 61-year-old woman presented with severe back pain and septic shock.
- Imaging revealed extensive soft tissue emphysema involving the L3 vertebral body and spinal canal.
- The patient underwent emergency surgical debridement.
Findings:
- Despite aggressive treatment, the patient succumbed to multisystem organ failure within 36 hours.
- This case highlights the devastating potential of NF in the spinal context.
- Literature review indicates only one prior reported case of spinal NF.
Implications:
- Spine surgeons must maintain a high index of suspicion for NF.
- Timely diagnosis and aggressive surgical debridement are paramount for improving outcomes.
- Awareness of this rare emergency can aid in critical decision-making for spine surgeons.
Related Concept Videos
01:16Unusual Results
According to the range rule of thumb, any value above or below two standard deviations, 2σ from the mean, μ is considered unusual.
Maximum unusual value =...
01:07z Scores and Unusual Values
This score indicates how far a value is from the mean in terms of standard deviation. For example, if a data value has a z score of +1, the researcher can infer that the particular data value is one standard deviation above the mean. If another data...
01:27Emerging Adulthood
01:23Inhaled Medications
01:30Introduction Cardiac Emergencies
01:26Antigens Involved in Adaptive Immunity
Complete Antigens
Complete antigens possess both immunogenicity and...