Devastating Vertebral Osteomyelitis after Epidural Steroid Injection: A Case Report

Case:A 62-year-old man with no comorbidities presented with back and bilateral leg pain and progressive paraplegia that developed over a 1-week period. He had received 2 lumbar epidural steroid injections (LESIs) for lumbar stenosis 39 and 25 days before presentation. Workup revealed osteomyelitis of L4 and L5 with epidural abscesses. He ultimately underwent all-posterior L4 and L5 corpectomy with reconstruction and L1-pelvis arthrodesis, followed by 8 weeks of intravenous antibiotics. His weakness improved, but neurological deficits persisted.Conclusions:This case illustrates a catastrophic complication after LESI, resulting in permanent neurological injury in a patient with no apparent risk factors.