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Spinal Epidural Abscess and Psoas Abscess Combined with Pyogenic Spondylodiscitis Following Vertebroplasty - A Case Report -

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2014, 21(2), pp.90-96
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery

Park， Jin-sung 1,  KIM DONG HEE ORD ID 2,  강번중 2,  Jeong Soon-Taek 1

1경상대학교
2경상대학교 의학전문대학원 정형외과학교실

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ABSTRACT

Study Design: Case report. Objective: To report a case of extensive spinal epidural abscess and bilateral psoas abscesses combined with pyogenic spondylodiscitisafter a L3 vertebroplasty. Summary of Literature Review: Infection after vertebroplasty or kyphoplasty is a rare medical complication. Few reports on spinalepidural abscess and bilateral psoas abscesses, coupled with pyogenic spondylodiscitis after vertebroplasty, are available in the Englishmedical literature. Materials and Methods: The authors performed a clinical and radiographic case review. Results: A 74-year-old woman, without any existing medical illness, presented with a history of three weeks of lower back pain, fever,and neurologic deficits of both legs after vertebroplasty performed in another hospital. Magnetic resonance imaging demonstratedan extensive spinal epidural abscess from T10 to S1 and huge bilateral psoas abscesses combined with spondylodiscitis at L3-4. Urgent limited laminectomies and abscess drainage were performed from L1 to S1. The day after the operation, ultrasound-guidedpercutaneous drainage was performed to manage bilateral psoas abscesses. Methicillin-resistant Staphylococcus aureus was identifiedby intraoperative culture. Antibiotic therapy during hospitalization was maintained for six weeks with vancomycin and rifampicin. Theinfection was successfully treated without any neurologic deficit and spinal deformity. Conclusions: Vertebroplasty is relative safe and simple procedure; however, the procedure also may cause severe spinal infection. Aseptic techniques under sterile environment was required during surgery. It is important that early diagnosis and prompt surgicaldecompression in spinal epidural abscess with neurologic deficit. Limited surgery and antibiotic therapy could be a good treatment optionin spinal epidural abscess combined with pyogenic spondylodiscitis. Key Words: spinal epidural abscess, psoas abscess, pyogenic spondylodiscitis, vertebroplasty, complication

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