Abstract
The collection of accurate information regarding the extent of paraspinal abscesses originating in the spine from various imaging modalities is of utmost importance before attempting any surgical drainage or manipulation. In this report, a patient is presented who had a lumbar laminectomy that was complicated by Staphylococcus aureus infection causing osteomyelitis of the vertebra and developed a paraspinal abscess in the lumbar spine which extended into the psoas muscle. The patient had two surgical operations procedures, the first for drainage of the abscess, and later an L-3 carpectomy for decompression of the cauda equina and fusion of L2 to L4. Computed tomography and MRI of the lumbar spine and Tc-99m MDP three-phase bone imaging with SPECT of the lumbar spine were performed. The reprojection display of the SPECT study was the most helpful preoperative finding in outlining the borders and extension of the abscess and for modifying the surgical approach.