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case_images: X-ray images showed uneven density and narrowing of the L2/3 intervertebral space (A and B). CT showed a cavity in the L2/3 segment of the vertebra, bone destruction involving most of the vertebra, and multiple irregular sequestrum (red arrow) within the lesion (C and D), Sagittal MRI showed vertebral body and intervertebral disc low T1 signal and high T2 signal. After enhancement, the abscess wall was significantly enhanced (E-H).
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case_images: L2/3 intervertebral space (Figure 1A and B). Lumbar CT and enhanced MRI showed cavities and osteolytic destruction in L2/3 with multiple irregular sequestrum, the paravertebral abscess was large and prominent. Subsequently, the patient underwent lumbar focus debridement, decompression, internal fixation, and bone graft fusion under general anesthesia (Figure 1C-H).
case_images: X-ray examination was performed on the third day after operation. The results showed that the internal fixation was firm and the position of the fusion cage was satisfactory.
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case_images: The X-ray reexamination on the third day after operation showed that the internal fixation was firm and the position of the fusion cage was satisfactory. (Figure 2) He was discharged 20 days later.
case_images: A mass at the incision site developed and ruptured at 4 months after operation.
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case_images: Four months after operation, the patient was found that the incision scar was swollen, with ulceration and pus (Figure 3), and was hospitalized again.
case_images: Lumbar CT and MRI: bilateral psoas major abscess formation, center liquefaction necrosis. Abnormal signals in the subcutaneous soft tissue of the lower back were considered inflammatory lesions and local sinus formation.
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case_images: The reexamination showed the formation of bilateral psoas abscess, central liquefaction necrosis, abnormal soft tissue density shadow under the lower back, considering inflammatory lesions, and local sinus formation. (Figure 4) After discussion with the general practitioner, the patient could be treated with ultrasound-guided puncture and drainage of pus (Figure 5), followed by surgical evacuation.
case_images: Ultrasound-guided right psoas major catheter drainage.
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case_images: The reexamination showed the formation of bilateral psoas abscess, central liquefaction necrosis, abnormal soft tissue density shadow under the lower back, considering inflammatory lesions, and local sinus formation. (Figure 4) After discussion with the general practitioner, the patient could be treated with ultrasound-guided puncture and drainage of pus (Figure 5), followed by surgical evacuation.