Related Experiment Video
Updated: Nov 4, 2025
A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients
Published on: October 25, 2024
Postoperative pain due to an occult spinal infection: A case report
Michiel Frederik Vande Kerckhove1, Vincent Fiere1, Thais Dutra Vieira2
1Centre Orthopédique Santy, Hopital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France.
Background:
A high degree of vigilance is warranted for a spinal infection, particularly in a patient who has undergone an invasive procedure such as a spinal injection. The average delay in diagnosing a spinal infection is 2-4 mo. In our patient, the diagnosis of a spinal infection was delayed by 1.5 mo.
Case Summary:
A 60-year-old male patient with a 1-year history of right-sided lumbar radicular pain failed conservative treatment. Six weeks to prior to surgery he received a spinal injection, which was followed by increasing lumbar radicular pain, weight loss and chills. This went unnoticed and surgery took place with right-sided L4-L5 combined microdiscectomy and foraminotomy via a posterior approach. The day after surgery, the patient developed left-sided lumbar radicular pain. Blood cultures grew Staphylococcus aureus (S. aureus). Magnetic resonance imaging showed inflammatory aberrations, revealing septic arthritis of the left-sided L4/L5 facet joint as the probable cause. Revision surgery took place and S. aureus was isolated from bacteriological samples. The patient received postoperative antibiotic treatment, which completely eradicated the infection.
Conclusion:
The development of postoperative lower back pain and/or lumbar radicular pain can be a sign of a spinal infection. A thorough clinical and laboratory work-up is essential in the preoperative evaluation of patients with spinal pain.
Insights
Prompt diagnosis of spinal infection is crucial, especially after procedures like spinal injections. Early detection and treatment of Staphylococcus aureus led to complete recovery in this case.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Orthopedic Surgery
Background:
- Spinal infections require high vigilance, particularly post-procedure.
- Delayed diagnosis of spinal infections averages 2-4 months.
- This case experienced a 1.5-month diagnostic delay.
Observation:
- A 60-year-old male presented with lumbar radicular pain, worsening after a spinal injection.
- Post-injection symptoms included increased pain, weight loss, and chills.
- The patient underwent lumbar microdiscectomy and foraminotomy, followed by new contralateral radicular pain.
Findings:
- Blood cultures identified Staphylococcus aureus (S. aureus).
- MRI revealed inflammatory changes consistent with septic arthritis of the L4/L5 facet joint.
- Revision surgery confirmed S. aureus infection.
Implications:
- Postoperative back or radicular pain may indicate spinal infection.
- Thorough clinical and laboratory evaluation is vital for patients with spinal pain.
- Prompt antibiotic treatment following surgical intervention led to complete infection eradication.
