Spinal Epidural Abscess After Radiofrequency Denervation of the Lumbar Facets: Case Report
1Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA.
Background:
Spinal epidural abscesses (SEAs) are rare with an estimated annual incidence of 0.2-2.8/10,000. Risk factors include immunosuppression, intravenous drug use, diabetes mellitus, HIV, trauma, tattooing, and bacteremia. Presenting symptoms are typically nonspecific with malaise, fever, back pain, and possible neurological deficits.
Case Report:
We present a case of SEA following radiofrequency ablation (RFA) in a patient with no known risk factors, in a 59-year-old man with axial lower back pain. The patient underwent an L4/L5 laminectomy and was started on antibiotics. His blood cultures grew Actinomyces and he was discharged with an extended course of antibiotics.
Conclusions:
While there have been reported SEAs after certain chronic pain procedures, they have not been reported after RFA to our knowledge. This is a novel presentation of an epidural abscess occurring solely after RFA, which should alert clinicians to the possibility of this complication.
Related Concept Videos
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...