J Korean Neurosurg Soc.  2008 Dec;44(6):385-388. 10.3340/jkns.2008.44.6.385.

Lumbar Periradicular Abscess Mimicking a Fragmented Lumbar Disc Herniation : An Unusual Case

• Bakar B
• Tekkok IH

• KMID: 1477500
• DOI: http://doi.org/10.3340/jkns.2008.44.6.385

Abstract

We herein describe the case of a focal spontaneous spinal epidural abscess who was initially diagnosed to have a free fragment of a lumbar disc. A 71-year-old woman presented with history of low back and right leg pain. Magnetic resonance imaging suggested a peripherally enhancing free fragment extending down from S1 nerve root axilla. Preoperative laboratory investigation showed elevation of c-reactive protein (CRP), erythrocyte sedimentation rate (ESR) levels. She was taken for surgery and a fluctuating mass at the axilla of S1 nerve was found. When the mass was probed with a dissector, a dark yellow, thick pus drained out. Pus cultures were negative. Patients who present with extreme low back plus leg pain and increased leucocyte count, ESR and CRP levels should raise the suspicion of an infection of a vertebral body or spinal epidural space.

Keyword

Abscess; Disc; Periradicular; Spinal

MeSH Terms

Abscess
Aged
Axilla
Blood Sedimentation
C-Reactive Protein
Epidural Abscess
Epidural Space
Female
Humans
Leg
Magnetic Resonance Imaging
Suppuration
C-Reactive Protein