Psoas Abscess After Lumbar Facet Joint Injection: Case Report and Literature Review

Ballestero, Matheus Fernando Manzolli; Carneiro, Vinícius Marques; Lima, Jose Paulo Luz; Oliveira, Ricardo Santos de

doi:10.7759/cureus.9559

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…Psoas abscess and intraspinal empyema are interconnected disease manifestations and often result from a local contiguous source. Psoas abscess formation after SI has mostly been reported in individual case reports and has been considered to be rare [ 26 , 27 ]. Nevertheless, in our cohort, more than a third of patients with SIVO developed psoas abscesses.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and outcome of vertebral osteomyelitis after spinal injection: is it worth the price?

et al. 2023

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Purpose Spinal injections are increasingly used for back pain treatment. Vertebral osteomyelitis (VO) after spinal injection (SIVO) is rare, but patient characteristics and outcome have not been well characterized. The aim of this study was to assess patient characteristics of SIVO in comparison to patients with native vertebral osteomyelitis (NVO) and to determine predictors for 1-year survival. Methods This is a single-center cohort study from a tertiary referral hospital. This is a retrospective analysis of Patients with VO who were prospectively enrolled into a spine registry from 2008 to 2019. Student’s t-test, Kruskal–Wallis test or Chi-square test were applied for group comparisons. Survival analysis was performed using a log-rank test and a multivariable Cox regression model. Results 283 VO patients were enrolled in the study, of whom 44 (15.5%) had SIVO and 239 (84.5%) NVO. Patients with SIVO were significantly younger, had a lower Charlson comorbidity index and a shorter hospital stay compared to NVO. They also showed a higher rate of psoas abscesses and spinal empyema (38.6% [SIVO] vs. 20.9% [NVO]). Staphylococcus aureus (27%) and coagulase-negative staphylococci (CNS) (25%) were equally often detected in SIVO while S. aureus was more frequently than CNS in NVO (38.1% vs. 7.9%).Patients with SIVO (P = 0.04) had a higher 1-year survival rate (Fig. 1). After multivariate analysis, ASA score was associated with a lower 1-year survival in VO. Conclusion The results from this study emphasize unique clinical features of SIVO, which warrant that SIVO should be estimated as a separate entity of VO.

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Section: Discussionmentioning

confidence: 99%

Clinical features and outcome of vertebral osteomyelitis after spinal injection: is it worth the price?

et al. 2023

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“…By the time of the last follow-up examination, no severe complications were observed in any of the cases. Furthermore, since percutaneous facet resolution may lead to complications, such as intravascular penetration, infection, hematoma, and vasovagal reactions [ 22 , 23 ], careful attention is essential during the procedure, and regular follow-up examinations are necessary to monitor the condition.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Percutaneous Image-Guided Rupture of Lumbar Facet Cysts: A Retrospective Study

Ishihara¹,

Morishita²,

Kanzaki

2023

Advances in Orthopedics

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Background. Percutaneous rupture of lumbar facet cysts (LFC) is the only nonsurgical treatment which is effective in directly reducing cysts. However, this is not yet a common procedure, and its effectiveness, including the associated complications, remains unclear. Therefore, this study aimed to evaluate the clinical outcomes of percutaneous rupture for LFC and elucidate whether this minimally invasive procedure could become an alternative to surgeries for cases resistant to conservative treatments. Methods. This study investigated 57 symptomatic patients with LFC for whom conservative treatments were ineffective and underwent percutaneous rupture of the LFC. All patients were followed up for >2 years posttreatment. Clinical evaluations (visual analogue scale (VAS) and recovery rate calculated using the Japanese Orthopedic Association (JOA) scores) and radiographic evaluations (size of LFC based on magnetic resonance imaging (MRI)) were performed from pretreatment to the final follow-up examination. Results. Successful LFC rupture, without hospitalization and general anesthesia, was achieved in 48 patients. No severe complications occurred during treatment through the last observation. Satisfactory clinical results with significant improvements in the VAS and JOA scores were obtained (VAS: pre/posttreatment: 80.7 mm/11.2 mm, JOA: pre/posttreatment: 15.6 points/26.7 points, and recovery rate: 82.3%). A significant reduction in the LFC was also observed in all cases based on the posttreatment MRI findings. No successful rupture cases required subsequent surgical treatments, although four cases of LFC recurrence required additional percutaneous rupture treatment. Conclusions. Percutaneous rupture for LFC is not only a safe and minimally invasive procedure without any severe complications or requirements for hospitalization and general anesthesia but also a beneficial procedure that can eliminate the need for surgery in cases resistant to conservative treatments.

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“…By the time of the last follow-up, no serious complications were found in any case. Because percutaneous facet resolution itself may lead to complications, such as intravascular penetration, infection, hematoma, and vasovagal reactions [21,22], careful attention is essential during the procedure and regular follow-up is necessary to monitor the condition.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of percutaneous rupture for lumbar facet cysts: A retrospective study

Kanzaki

Morishita²,

Ishihara³

2022

Preprint

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Background: Percutaneous rupture of lumbar facet cysts (LFC) is the only non-surgical treatment able to directly reduce cysts. However, this is not yet a common procedure, and its effectiveness, including the evaluation of complications, remains unclear. This study aimed to evaluate the clinical outcomes of percutaneous rupture for LFC and elucidate whether this minimally invasive procedure could become an alternative to surgeries for cases resistant to conservative treatments. Methods: This study investigated 51 symptomatic patients with LFC for whom conservative treatments were ineffective and who underwent percutaneous rupture of the LFC. All patients were followed-up for >2 years after the treatment. Clinical evaluations (Visual Analogue Scale [VAS], recovery rate calculated with Japanese Orthopedic Association scores) and radiographic evaluations (size of LFC based on magnetic resonance imaging [MRI]) were performed from pretreatment to final follow-up. Results: Successful LFS rupture, without hospitalization and general anesthesia, was achieved in 43 patients. No serious complications occurred during treatment through the last observation. Satisfactory clinical results were obtained (VAS: 11.1 mm, recovery rate: 83.1 %), and significant reduction of LFC was recognized in all cases based on post-treatment MRI. No successful rupture cases required subsequent surgical treatments, although there were 3 cases of LFC recurrence that required an additional percutaneous rupture treatment. Conclusions: Percutaneous rupture for LFC is not only a safe and minimally invasive procedure without any serious complications or requirements for hospitalization and general anesthesia, but also a very useful procedure that can prevent surgery for cases resistant to conservative treatments.

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Psoas Abscess After Lumbar Facet Joint Injection: Case Report and Literature Review

Cited by 4 publications

References 18 publications

Clinical features and outcome of vertebral osteomyelitis after spinal injection: is it worth the price?

Clinical features and outcome of vertebral osteomyelitis after spinal injection: is it worth the price?

Efficacy of Percutaneous Image-Guided Rupture of Lumbar Facet Cysts: A Retrospective Study

Usefulness of percutaneous rupture for lumbar facet cysts: A retrospective study

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