Ballestero Matheus F M, Carneiro Vinícius, Luz Lima Jose Paulo, Santos de Oliveira Ricardo
Department of Medicine, Federal University of São Carlos, Sao Carlos, BRA.
Department of Surgery and Anatomy, Clinics Hospital of Ribeirão Preto of the University of São Paulo, University of São Paulo, Ribeirão Preto, BRA.
Cureus. 2020 Aug 4;12(8):e9559. doi: 10.7759/cureus.9559.
Low back pain (LBP) is a common condition. It is estimated that 84% of adults will present LBP symptoms at some point in their lives. Rarely, however, is LPB an indication of a serious medical condition, requiring further investigation. The treatment of non-specific LBP is based on non-pharmacological strategies, e.g., non-steroidal anti-inflammatory drugs (NSAID) or skeletal muscle relaxants. The use of epidural steroid injection (ESI) or facet joint injections relieves pain originating from degenerative spine disorders or a disk herniation, thereby providing rapid pain improvement, despite considerable long-term outcomes. Although rare, ESI complications can occur, and infections are infrequently described. This paper describes a rare case of an abscess in the psoas muscle, secondary to facet joint lumbar block. We report a male aged between 30 and 40 years old with LBP, who was submitted to a facet joint and ESI. The procedure evolved into a spinal infection of the psoas muscle. In addition, we present a brief literature review on psoas infections after spinal injection. Infection post facet joint lumbar block is very rare, with few publications in the literature. Early detection and the aggressive broad-spectrum antibiotic course must be initiated until adequate cultures are obtained and antibiotics prolong to at least four weeks.
腰痛（LBP）是一种常见病症。据估计，84%的成年人在其一生中的某个阶段会出现腰痛症状。然而，腰痛很少是严重疾病的指征，需要进一步检查。非特异性腰痛的治疗基于非药物策略，例如非甾体抗炎药（NSAID）或骨骼肌松弛剂。硬膜外类固醇注射（ESI）或小关节注射可缓解源自退行性脊柱疾病或椎间盘突出的疼痛，从而迅速改善疼痛，尽管长期效果相当可观。虽然罕见，但ESI并发症可能发生，且感染情况鲜有描述。本文描述了一例因小关节腰椎阻滞继发腰大肌脓肿的罕见病例。我们报告了一名30至40岁患有腰痛的男性，他接受了小关节注射和ESI。该手术演变成了腰大肌的脊柱感染。此外，我们对脊柱注射后腰大肌感染进行了简要的文献综述。小关节腰椎阻滞后感染非常罕见，文献中鲜有报道。必须尽早发现并积极使用广谱抗生素疗程，直至获得足够的培养物且抗生素疗程延长至至少四周。
