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영어

Spinal infection is a rare but potentially life-threatening condition that may occur spontaneously or following spinal interventions. Early diagnosis and treatment are critical for favorable outcomes, and clinical suspicion followed by appropriate imaging is crucial. We report a rare case of suspected spontaneous hematogenous spinal infection that developed shortly after lumbar transforaminal epidural neuroplasty. A 77-year-old male patient underwent lumbar transforaminal epidural neuroplasty for recurrent radicular pain. He developed worsening leg pain the following evening, later accompanied by fever. Laboratory tests revealed elevated inflammatory markers. Initial MRI on post-procedure day 5 showed nonspecific findings; however, a follow-up MRI on day 12 demonstrated spontaneous hematogenous spondylitis with an epidural abscess. Conservative management with prolonged intravenous antibiotics was performed, and the patient’s symptoms and laboratory markers gradually improved. This case highlights the importance of early suspicion, repeated MRI when initial imaging is inconclusive, and consideration of spontaneous hematogenous spinal infection as a potential etiology, even after interventional procedures.