Case of osteomyelitis caused by Cutibacterium acnes after full-endoscopic spinal surgery.

BACKGROUND

Full-endoscopic spinal surgery (FESS) is an effective technique for reducing the risk of surgical site infection. However, postoperative infections do occur but are only rarely reported.

CASE DESCRIPTION: A 71-year-old male underwent a left L45 FESS for foraminal stenosis and disc herniation. Postop day 40, he developed the sudden onset of severe low back pain/sciatica. Although he remained afebrile and laboratory tests showed only mild inflammation (C-reactive protein: 2.1 mg/dL, white blood cell count within the normal range), the lumbar magnetic resonance and computed tomography (CT) studies revealed L4/5 osteomyelitis. The CT-guided biopsy documented Cutibacterium acnes (formerly Propionibacterium acnes), and the patient responded well to antibiotic treatment alone, without requiring additional surgical intervention.

CONCLUSION

This case describes the 40-day delayed postoperative-onset of osteomyelitis following a right L45 FESS caused by C. acnes.