Case report of an abscess developing at the site of a hematoma following a direct lateral interbody fusion

Abstract

A direct lateral interbody fusion (DLIF) is relatively new, yet commonly performed procedure in spine surgery. This procedure is associated with risk, including damage to nerve or vascular structures. However, to our knowledge, there has not been a case of an abscess developing at the site of a postoperative hematoma after this procedure. The objective was to document a case of the delayed presentation of an abscess at the site of a postoperative hematoma after a DLIF. The study was designed to be a case report and literature review. We present a case of a 63-year-old patient who developed a large retroperitoneal hematoma after an L2-L5 DLIF. The patient developed a postoperative urinary tract infection with cultures positive for Pseudomonas. The infection was treated with oral antibiotics. Eight months after her procedure, the patient was found to have developed an abscess (measuring 11.6 × 8.4 × 10.0 cm) at the site of the prior hematoma. After radiological-guided aspiration and a 2-week course of oral antibiotics, the abscess resolved and the patient recovered with no sequelae. Direct lateral interbody fusion is a minimally invasive procedure that may result in postoperative hematoma formation. We have reported a case of the development of an abscess at the site of a postoperative hematoma.