Extensive Neuromusculoskeletal Complications—Including Multi-Level Vertebral Osteomyelitis, Myelopathy, Polyradiculopathy, and Multiple Muscle Abscesses—After Lumbar Transforaminal Epidural Block: A Case Report

Abstract

Vertebral osteomyelitis (VO) is a rare, slowly progressing disease that often causes neuromuscular complications. Epidural block is a non-surgical treatment used in patients with radicular pain to deliver drugs to the epidural space; it is generally known to be a safe method, but it can occasionally cause infection. Herein, we present a rare case of VO with severe neuromuscular complications that developed in a patient who underwent lumbar transforaminal epidural block for back pain. Imaging studies showed VO, multiple pyogenic abscesses, and compressive cervical myelopathy. Electrodiagnostic studies showed clear evidence of cervical myelopathy and polyradiculopathy. With early treatment using a multidisciplinary approach, including medical treatment, surgery, and comprehensive rehabilitation, recovery of motor weakness and functional improvement were achieved after 2 months of treatment. Electrodiagnostic studies are advantageous for localizing and determining the degree of neuromuscular damage following VO. A multidisciplinary approach to the diagnosis and treatment of VO could improve patients’ prognosis, functional ability, and quality of life.