Generalized infection following facet joint injection -A case report-

Abstract

Facet joints have been shown to be a source of chronic low back pain, and it is generally accepted in clinical practice that diagnostic and therapeutic facet joint injections are the most reliable technique for the treatment of facet joint pain, which is considered to be an easy and safe procedure. Serious complications and side effects are uncommon after facet joint injection. However, infectious complications including septic arthritis, epidural abscess, meningitis and endocarditis have been reported following facet joint injections. We report here the first case of death following lumbar facet joint injection due to generalized infection.

Subdural empyema following lumbar facet joint injection: An exceeding rare complication

“…Systematic review of the literature with relevance to serious infective complications yielded eight case reports describing nine patients [10][11][12][13][14][15][16][17]. One report detailed a patient who developed an isolated epidural abscess following facet joint injection [10].…”

“…Another reported development of infective endocarditis with a paraspinal abscess [16]. Finally, one report documented a patient with generalised sepsis leading to multiple organ failure and death following a facet joint injection [17].…”

“…In conclusion, prevention of development of infection post facet joint injection should always be paramount when considering any invasive treatment for facet pain syndrome. This is best achieved by employing rigorous asepsis and limiting both the frequency of injections, and the number of simultaneous injections [17].…”

Idiopathic septic arthritis of a lumbar facet joint associated with paraspinal abscess

“…Despite increasing knowledge of the condition and modern diagnostic imaging investigations, the management of SAFJ is still a challenge due to the resistant microorganisms causing septicaemia and consequent mortality 2 14…”

Septic arthritis of unilateral lumbar facet joint with contiguous abscess, without prior intervention

“…With improved imaging technology, availability of MRI and heightened awareness, this rare infection can be diagnosed early, however, the growth in resistant strains of bacteria complicates the situation. Some cases of septic arthritis that develop into abscesses can even result in death,19 20 a high index of clinical suspicion can prevent such mortality.…”