Case report of minimally invasive spinal endoscopic debridement and pedicle screw fixation for severe spinal infection of the lumbosacral spine

Abstract

Background: Surgical treatment of spinal infections, refractory to medical treatments, is increasing in incidence. Here, we present a unique case of discitis secondary to an iatrogenic cause, spinal steroid injection, that resulted in acute neurology, ventral phlegmon, and osteomyelitis requiring multiple surgical interventions for treatment. Case Description: With the adoption of minimally invasive spinal surgery, the patient underwent full endoscopic debridement and decompression at our hospital. The endoscopic technique offers a unique avenue to the anatomically difficult ventral phlegmon for surgical excision, cultures, and pathogen identification. The endoscopic debridement was paired with percutaneous pedicle screw fixation to stabilize the spine from the worsening bone destruction. Outcome: The patient recovered well postoperatively, with the resolution of her neurological symptoms and improved mobility. Conclusions: Full endoscopic spinal debridement and decompression is a powerful tool to manage severe spinal discitis and preliminary studies encourage its adoption in surgical practices.

Keywords

• Endoscopic spinal debridement
• Spinal injection
• Discitis
• Vertebral osteomyelitis
• Spondylodiscitis
• Ventral phlegmon