1. Lumbosacral Osteomyelitis and Discitis with Phlegmon Following Laparoscopic Sacral Colpopexy
- Author
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Danielle D. Antosh, Robert A. Scranton, Richard K. Simpson, and Amanda V Jenson
- Subjects
medicine.medical_specialty ,discitis ,sacral colpopexy ,Neurosurgery ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,Phlegmon ,medicine ,Back pain ,030212 general & internal medicine ,030219 obstetrics & reproductive medicine ,business.industry ,Osteomyelitis ,General Engineering ,osteomyelitis ,Hematogenous Spread ,medicine.disease ,Surgery ,body regions ,Discitis ,Obstetrics/Gynecology ,medicine.symptom ,business ,Complication ,Lumbosacral joint - Abstract
Lumbosacral osteomyelitis and discitis are usually a result of hematogenous spread; rarely it can result from direct inoculation during a surgical procedure. Bacteria may also track along implanted devices to a different location. This is a rare complication seen from pelvic organ prolapse surgery with sacral colpopexy. A 67-year-old female developed increasing lower back pain four months following a laparoscopic sacral colpopexy. Imaging revealed lumbar 5-sacral 1 (L5-S1) osteomyelitis and discitis with associated phlegmon confirmed by percutaneous biopsy and culture. The patient was treated conservatively with antibiotics, but required laparoscopic removal of the pelvic and vaginal mesh followed by twelve weeks of intravenous antibiotics. The patient has experienced clinical improvement of her back pain. This is an uncommon complication of sacral colpopexy, but physicians must be vigilant and manage aggressively to avoid more serious complications and permanent deficit.
- Published
- 2016
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