Discitis Lateral

A 44 year-old man underwent elective disk surgery at the L2-L3 level. Three days later, he developed low back pain associated with fever. The next day, he developed numbness and weakness of both legs.

Diskitis and Vertebral Osteomyelitis: Sagittal MRIs of the Lumbar Spine; (Left) T1-weighted image; (Right) T1-weighted with gadolinium image. Note the destructive process at the L2-L3 interspace, that enhances with gadolinium and spreads into the adjacent thecal sac. This is a case of diskitis and adjacent osteomyelitis with subsequent inflammation and compression of the cauda equina.

Infection of the disk and surrounding tissues most often occurs from spread through the blood system to the vertebral body, directly to the epidural space, or both. However, it can also occur as an operative complication. Patients most often present subacutely over days with fever and spine pain, often followed by radicular symptoms and then frank spinal cord or cauda equina compromise.