Acute osteomyelitis of the spine with paraplegia

A case is reported of acute osteomyelitis of the lumbar spine presenting with a psoas abscess which extended into the epidural space mimicking an epidural abscess. The patient also had severe septicaemia and a complete cauda equina lesion. The septicaemia was controlled by draining the abscess by an anterior approach to the lumbar spine. Decompression of the cord was achieved by removing the sequestrated discs, the necrotic body of the fourth lumbar vertebra and draining the epidural abscess by opening the posterior longitudinal ligament.