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Jenson M D AV, Scranton R, Antosh DD, et al. Lumbosacral Osteomyelitis and Discitis with Phlegmon Following Laparoscopic Sacral Colpopexy. Cureus. 2016;8(7):e671doi: 10.7759/cureus.671.
Jenson M D, A. V., Scranton, R., Antosh, D. D., & Simpson, R. K. (2016). Lumbosacral Osteomyelitis and Discitis with Phlegmon Following Laparoscopic Sacral Colpopexy. Cureus, 8(7), e671. https://doi.org/10.7759/cureus.671
Jenson M D, Amanda V, et al. "Lumbosacral Osteomyelitis and Discitis with Phlegmon Following Laparoscopic Sacral Colpopexy." Cureus vol. 8,7 (2016): e671. doi: https://doi.org/10.7759/cureus.671
Jenson M D AV, Scranton R, Antosh DD, Simpson RK. Lumbosacral Osteomyelitis and Discitis with Phlegmon Following Laparoscopic Sacral Colpopexy. Cureus. 2016 Jul 05;8(7):e671. doi: 10.7759/cureus.671. PMID: 27551651; PMCID: PMC4977220.
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Cureus. 2016 Jul 05;8(7):e671. doi: 10.7759/cureus.671.

Lumbosacral Osteomyelitis and Discitis with Phlegmon Following Laparoscopic Sacral Colpopexy.

Cureus

Amanda V Jenson M D, Robert Scranton, Danielle D Antosh, Richard K Simpson

Affiliations

  1. Department of Neurosurgery, Houston Methodist Neurological Institute.
  2. Division of Urogynecology, Houston Methodist Hospital.

PMID: 27551651 PMCID: PMC4977220 DOI: 10.7759/cureus.671

Abstract

Lumbosacral osteomyelitis and discitis are usually a result of hematogenous spread; rarely it can result from direct inoculation during a surgical procedure. Bacteria may also track along implanted devices to a different location. This is a rare complication seen from pelvic organ prolapse surgery with sacral colpopexy. A 67-year-old female developed increasing lower back pain four months following a laparoscopic sacral colpopexy. Imaging revealed lumbar 5-sacral 1 (L5-S1) osteomyelitis and discitis with associated phlegmon confirmed by percutaneous biopsy and culture. The patient was treated conservatively with antibiotics, but required laparoscopic removal of the pelvic and vaginal mesh followed by twelve weeks of intravenous antibiotics. The patient has experienced clinical improvement of her back pain. This is an uncommon complication of sacral colpopexy, but physicians must be vigilant and manage aggressively to avoid more serious complications and permanent deficit.

Keywords: discitis; osteomyelitis; sacral colpopexy

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