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Infection of disk space secondary to fistula from pelvic abscess

E J Gordon

    Southern Medical Journal
    |January 1, 1977
    PubMed

    Insights

    Disk space sepsis following spinal surgery can be complicated by rare pelvic abscess fistulas. Early diagnosis and surgical intervention, including drainage and abscess evacuation, are crucial for successful patient outcomes.

    Area of Science:

    • Spinal Surgery
    • Infectious Disease
    • Radiology

    Background:

    • Disk space sepsis is a known complication of spinal surgery.
    • Infection via a penetrating fistula from a retroperitoneal or pelvic abscess is an uncommon presentation.
    • The subtle clinical presentation and imaging findings can mimic herniated disk syndrome, delaying diagnosis.

    Observation:

    • A patient presented with symptoms suggestive of a herniated disk.
    • Diagnostic workup revealed an obscured primary infection source.
    • The insidious nature of the infection complicated initial assessment.

    Findings:

    • Laminectomy and drainage of the lumbosacral disk space were performed.
    • A diagnostic fistulogram identified a large pelvic abscess.
    • Evacuation of the pelvic abscess was successfully achieved.

    Implications:

    • This case highlights the importance of considering rare infectious etiologies in spinal surgery complications.
    • Prompt diagnosis and multi-pronged surgical management are key to favorable outcomes.
    • Effective identification and treatment of the primary abscess source are critical for resolving disk space sepsis.

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