Multiple recurrent postoperative spinal infections due to an unrecognized presacral abscess following placement of bicortical sacral screws: case report

Laura Bloom, S. Shelby Burks, Allan D Levi

Research output: Contribution to journalArticle

Abstract

Postoperative wound infections in spinal surgery remain an important complication to diagnose and treat successfully. In most cases of deep infection, even with instrumentation, aggressive soft-tissue debridement followed by intravenous antibiotics is sufficient. This report presents a patient who underwent L3-S1 laminectomy and pedicle screw placement including bicortical sacral screws. This patient went on to develop multiple (7) recurrent infections at the operative site over a 5-year period. Continued investigation eventually revealed a large presacral abscess, which remained the source of recurrent bacterial seeding via the remaining bone tracts of the bicortical sacral screws placed during the original lumbar surgery. Two years after drainage of this presacral collection via a retroperitoneal approach, the patient remains symptom free.

Original languageEnglish (US)
Pages (from-to)502-505
Number of pages4
JournalJournal of neurosurgery. Spine
Volume24
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

Abscess
Infection
Surgical Wound Infection
Laminectomy
Debridement
Drainage
Anti-Bacterial Agents
Bone and Bones
Pedicle Screws

Keywords

  • I & D = incision and drainage
  • instrumentation
  • IV = intravenous
  • methicillin-resistant Staphylococcus aureus
  • MRSA = methicillin-resistant Staphylococcus aureus
  • paraspinal and presacral
  • postoperative infection
  • spine
  • SSI = surgical site infection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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abstract = "Postoperative wound infections in spinal surgery remain an important complication to diagnose and treat successfully. In most cases of deep infection, even with instrumentation, aggressive soft-tissue debridement followed by intravenous antibiotics is sufficient. This report presents a patient who underwent L3-S1 laminectomy and pedicle screw placement including bicortical sacral screws. This patient went on to develop multiple (7) recurrent infections at the operative site over a 5-year period. Continued investigation eventually revealed a large presacral abscess, which remained the source of recurrent bacterial seeding via the remaining bone tracts of the bicortical sacral screws placed during the original lumbar surgery. Two years after drainage of this presacral collection via a retroperitoneal approach, the patient remains symptom free.",
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