Spinal Epidural Abscess After Radiofrequency Denervation of the Lumbar Facets: Case Report.

BACKGROUND

Spinal epidural abscesses (SEAs) are rare with an estimated annual incidence of 0.2-2.8/10,000. Risk factors include immunosuppression, intravenous drug use, diabetes mellitus, HIV, trauma, tattooing, and bacteremia. Presenting symptoms are typically nonspecific with malaise, fever, back pain, and possible neurological deficits.

CASE REPORT: We present a case of SEA following radiofrequency ablation (RFA) in a patient with no known risk factors, in a 59-year-old man with axial lower back pain. The patient underwent an L4/L5 laminectomy and was started on antibiotics. His blood cultures grew Actinomyces and he was discharged with an extended course of antibiotics.

CONCLUSIONS

While there have been reported SEAs after certain chronic pain procedures, they have not been reported after RFA to our knowledge. This is a novel presentation of an epidural abscess occurring solely after RFA, which should alert clinicians to the possibility of this complication.