Vertebral osteomyelitis resulting in cauda equina syndrome and urinary retention

Case contributed by Michael P Hartung


6 weeks of urinary retention managed with foley catheter, evaluate for cause.

Patient Data

Age: 70 years
Gender: Male

L3/L4 endplate destruction with paraspinal abscess and phlegmon, resulting in severe narrowing of the spinal canal.

Bladder decompressed with foley catheter. Mild bilateral hydroureteronephrosis.

Case Discussion

Cauda equina syndrome due to paraspinal phlegmon/abscess causing lumbosacral nerve root compression, resulting in several weeks of urinary retention. The patient did not complain of back pain at the time of presentation, and was instead thought to have BPH as the cause. This is considered a diagnostic and surgical emergency, as decompression within 24 hours typically has the best outcomes.

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