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Lumbar facet joint infection associated with epidural and paraspinal abscess
M S Baltz1, D E Tate, J A Glaser
1Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston 29425, USA.
Abstract:
A case of lumbar facet joint infection associated with abscesses of the paraspinal muscles and the epidural space is presented. The infection did not respond to intravenous antibiotic therapy and resolved only after incision and drainage of the epidural space, involved facet joint, and paraspinal musculature. Magnetic resonance imaging, which showed a widened facet joint, epidural abscess, and paraspinal involvement, aided in diagnosis and preoperative planning. This condition is rare, and this report outlines some clinical characteristics of the infection and the usefulness of magnetic resonance imaging in visualizing the extent of the infection.
Insights
A rare lumbar facet joint infection with paraspinal and epidural abscesses required surgical drainage after antibiotics failed. Magnetic resonance imaging was crucial for diagnosis and surgical planning.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Radiology
Background:
- Lumbar facet joint infections are uncommon but can lead to serious complications.
- Abscess formation in paraspinal muscles and the epidural space can accompany facet joint infections.
Observation:
- A patient presented with a lumbar facet joint infection complicated by paraspinal and epidural abscesses.
- Initial treatment with intravenous antibiotics was ineffective.
Findings:
- Surgical intervention, including incision and drainage of the epidural space, facet joint, and paraspinal muscles, led to resolution.
- Magnetic resonance imaging effectively visualized the extent of the infection, including a widened facet joint, epidural abscess, and paraspinal involvement, aiding diagnosis and surgical planning.
Implications:
- This case highlights the importance of considering surgical management for refractory lumbar facet joint infections with associated abscesses.
- Magnetic resonance imaging is a valuable tool for diagnosing and planning treatment for these rare infections.
- Early and accurate diagnosis through advanced imaging is critical for successful outcomes.