A Rare Complication of Sepsis Following L4–l5 Microdiscectomy for Prolapsed Intervertebral Disc With Radiculopathy

Abstract

Introduction

Prolapsed intervertebral disc at L4-L5 with microdiscectomy is common due to a history of trauma, twisting, and negligence of heavy lifting, but postoperative wound infection, although uncommon, can lead to significant morbidity and delayed recovery. This can lead to an array of future complications. Sometimes it may be caused by negligence. Case Presentation: Here we present a case of negligence in heavy lifting, and the patient was admitted with complaints of severe back pain, tingling sensations, and body stiffness. The patient was apparently well one month ago. Then she started experiencing pain in the lower back, which was radiating and shooting in nature. The pain was associated with a tingling sensation in the right leg. It was aggravated by movement and relieved by rest. After radiological investigation, the patient was diagnosed as having a prolapsed intervertebral disc at the L4–L5 level with radiculopathy. Conservative management failed. The patient underwent microdiscectomy at L4-L5. Patient's condition was in the recurrence stage; again, the patient underwent laboratory and radiological investigations. Again, the doctor planned for wound exploration and resuturing due to pus formation at the suture site of Staphylococcus infection. The patient again underwent general anesthesia for wound exploration and re-suturing, with a drain. The postoperative patient received one unit of PRC in view of anemia and wound infection, and was managed with antibiotics and painkillers; the drain was removed and sutured. Dressing done, wound healed, and discharged in stable condition.

Conclusion

This case highlights that proper surgical and medical management is required to avoid postoperative wound infection, even though microdiscectomy is an effective surgical treatment for a prolapsed intervertebral disc with radiculopathy. To prevent possible complications, proper surgical asepsis, postoperative wound care, early identification of infection, and patient education regarding activity restriction are essential. For achieving the required outcomes, early intervention and appropriate antibiotic therapy play an important role.