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A Good Outcome Following Delayed Debridement of Lumbar Paraspinal Abscess after Postoperative Epidural Catheterization: Case Report

Authors:

Azizul Akram Salim ,

Universiti Sains, Malaysia, MY
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Dayang Shariza Abang Abdillah,

Universiti Sains, Malaysia, MY
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Hong Chun Lim,

Universiti Sains, Malaysia, MY
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Joehaimey Johari,

Universiti Sains, Malaysia, MY
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Mohd Imran Yusof

Universiti Sains, Malaysia, MY
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Abstract

Paraspinal abscess or clinically significant soft tissue infection following epidural analgesia is a rare but serious complication if left untreated. We report a 54-year-old gentleman with underlying chronic diabetes mellitus who had a motor vehicle accident and had undergone several surgeries. A course of steroid was provided for delayed left lower motor neuron facial nerve palsy (House-Brackmann stage 4). The epidural catheter was inserted with a single attempt at the L3/L4 level. One month later, he complained of crippling lower back pain and growing swelling with a punctum. MRI showed a paraspinal abscess with bilateral involvement of the spinae erector. This report is intended to highlight the excellent outcome of surgical treatment for paraspinal abscess despite the late presentation. A high level of suspicion should be taken into account when the patient is immunocompromised, particularly with steroid use and chronic diabetes mellitus. Early detection via MRI, high suspicion index and immediate surgery have extraordinary benefits in managing paraspinal abscesses.
How to Cite: Salim, A.A., Abang Abdillah, D.S., Lim, H.C., Johari, J. and Yusof, M.I., 2021. A Good Outcome Following Delayed Debridement of Lumbar Paraspinal Abscess after Postoperative Epidural Catheterization: Case Report. Sri Lankan Journal of Anaesthesiology, 29(2), pp.131–133. DOI: http://doi.org/10.4038/slja.v29i2.8701
Published on 16 Nov 2021.
Peer Reviewed

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