Asian Spine J.  2007 Jun;1(1):61-64. 10.4184/asj.2007.1.1.61.

Spinal Epidural Abscess with Pyogenic Arthritis of Facet Joint Treated with Antibiotic-Bone Cement Beads: A Case Report

• Lee BJ
• Lee SR
• Kim ST
• Kim TH
• Lee SH

• KMID: 1908152
• DOI: http://doi.org/10.4184/asj.2007.1.1.61

Abstract

Most epidural abscesses are a secondary lesion of pyogenic spondylodiscitis. An epidural abscess associated with pyogenic arthritis of the facet joint is quite rare. To the best of our knowledge, there is no report of the use of antibiotic-cement beads in the surgical treatment of an epidural abscess. This paper reports a 63-year-old male who sustained a 1-week history of radiating pain to both lower extremities combined with lower back pain. MRI revealed space-occupying lesions, which were located in both sides of the anterior epidural space of L4, and CT scans showed irregular widening and bony erosion of the facet joints of L4-5. A staphylococcal infection was identified after a posterior decompression and an open drainage. Antibiotic- bone cement beads were used as a local controller of the infection and as a spacer or an indicator for the second operation. An intravenous injection of anti-staphylococcal antibiotics resolved the back pain and radicular pain and normalized the laboratory findings. We point out not only the association of an epidural abscess with facet joint infection, but also the possible indication of antibiotic-bone cement beads in the treatment of epidural abscesses.

Keyword

Epidural abscess; Facet joint infection; Lumbar spine; Antibiotic-bone cement bead

MeSH Terms

Anti-Bacterial Agents
Arthritis*
Back Pain
Decompression
Discitis
Drainage
Epidural Abscess*
Epidural Space
Humans
Injections, Intravenous
Low Back Pain
Lower Extremity
Magnetic Resonance Imaging
Male
Middle Aged
Staphylococcal Infections
Tomography, X-Ray Computed
Zygapophyseal Joint*
Anti-Bacterial Agents