Spinal Epidural Abscess Following Administration of Epidural Steroid Injection for Low Backache Ã¢ÂÂ Need for Urgent Diagnosis and Intervention
Manish Joseph Mathew, Amey R Savardekar* and Nupur Pruthi
Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, India
- *Corresponding Author:
- Amey R Savardekar
Assistant Professor, Department of Neurosurgery
National Institute of Mental Health and Neurosciences, Bengaluru, India
E-mail: [email protected]
Received date: April 18, 2017; Accepted date: April 27, 2017; Published date: April 29, 2017
Citation: Mathew MJ, Savardekar AR, Pruthi N (2017) Spinal Epidural Abscess Following Administration of Epidural Steroid Injection for Low Backache – Need for Urgent Diagnosis and Intervention. J Spine 6:371. doi: 10.4172/2165-7939.1000371
Copyright: © 2017 Mathew MJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Epidural steroid injection is an innocuous and efficient modality of treatment for chronic low back ache due to a multitude of causes, its use being on the rise in recent times. However, a note needs to be made regarding the potentially serious complications following epidural steroid injection including epidural space infection. This condition requires a high index of suspicion for early diagnosis and treatment.
Case presentation: A 39-year-old lady presented, following a second episode of epidural steroid injection, with change in nature and increased severity of low back ache. Magnetic Resonance Imaging (MRI) of the lumbosacral spine showed a T1 hypointense, T2 hyperintense peripherally enhancing epidural collection at L3-L5 level for which she underwent laminectomy and evacuation of collection with complete relief of pain. Intraoperatively, there was a non-foul smelling, thick, yellowish pus which turned out to be positive for Staphylococcus aureus.
Conclusion: Spinal epidural abscess is a rare complication following epidural steroid injection which requires a high degree of suspicion for early detection and treatment, to prevent permanent neurological sequela.