case_images: PMC9375553_01
case_images: X-ray radiographs at admission. Lateral (A) and anteroposterior (B) radiographs show grade I L4 spondylolisthesis and loss of height of L4-5 disc (red arrow).
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case_images: PMC9375553_01_IDR-15-4361-g0001.jpg
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case_images: X-ray (Figure 1A and B), magnetic resonance imaging (MRI) (Figure 2A and B) and computed tomography (CT) (Figure 3A and B) scans showed abnormality in his L3-5 lumbar segment. 
case_images: Fat-suppressed T2-weighted MRI images at different time-points. (A) Sagittal MRI image at admission; (B) axial MRI image of L4-5 disc space at admission; (C) sagittal MRI image at 78 days after admission; (D) axial MRI image of L4-5 disc space at 78 days after admission; (E) sagittal MRI image at re-examination; (F) axial MRI image of L4-5 disc space at re-examination. Red arrows indicate hyperintense signal in vertebral bodies and paravertebral tissue. Pink arrow indicates spinal canal abscess. Blue arrow indicates paravertebral soft tissue abscess. The damaged area was extended at 78 days after admission but relieved at re-examination.
case_images: IDR-15-4361-g0002.jpg
case_images: PMC9375553_01_IDR-15-4361-g0002.jpg
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case_images: X-ray (Figure 1A and B), magnetic resonance imaging (MRI) (Figure 2A and B) and computed tomography (CT) (Figure 3A and B) scans showed abnormality in his L3-5 lumbar segment.  Major lumbar spinal infection and vertebral destruction were noticed on MRI (Figure 2C and D) and CT (Figure 3C and D) scans. The MRI results showed that the lumbar spinal infection was alleviated compared with the previous observation (Figure 2E and F).
case_images: CT images at different time-points. (A) Sagittal CT image at admission; (B) axial CT image at admission; (C) sagittal CT image at 78 days after admission; (D) axial CT image at 78 days after admission; (E) sagittal CT image at re-examination; (F) axial CT image at re-examination. Red arrow indicates slight L3-5 vertebral body destruction with grade I L4 spondylolisthesis. Oval indicates broader and more severe L3-5 damage including grade II L4 spondylolisthesis, L4-5 disc space disappearance and L3-5 vertebral body destruction. White arrow indicates new bone formation.
case_images: IDR-15-4361-g0003.jpg
case_images: PMC9375553_01_IDR-15-4361-g0003.jpg
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case_images: X-ray (Figure 1A and B), magnetic resonance imaging (MRI) (Figure 2A and B) and computed tomography (CT) (Figure 3A and B) scans showed abnormality in his L3-5 lumbar segment.  Major lumbar spinal infection and vertebral destruction were noticed on MRI (Figure 2C and D) and CT (Figure 3C and D) scans. New bone formation and osteosclerotic changes were observed on CT images (Figure 3E and F).
case_images: (A) H&E staining of L4-5 disc space tissues shows typical characteristics of acute and chronic inflammatory cell infiltration; (B) MRI image shows an obvious swelling (red arrow) in the patient's thigh.
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case_images: PMC9375553_01_IDR-15-4361-g0004.jpg
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case_images: Pathological results revealed fibrous tissue hyperplasia accompanied by acute and chronic inflammatory cell infiltration; locally, degeneration, necrosis and dead bone formation were also noticed (Figure 4A). After the emergency had been brought under control, the patient was sent back to our department, where obvious swelling in the patient's thigh was noticed (Figure 4B).