History :
L5-S1 Spine Infection Treatment became necessary for a 38-year-old female from Pune who had previously undergone L5-S1 discectomy at an outside hospital. Three months after her surgery, she began suffering from severe low back pain radiating to both legs, more on the left. Over the past month, the pain worsened. She also reported difficulty keeping her left sandal on and experienced tingling and numbness in her right leg. The pain intensified to the point where she could neither walk nor sit.
Initially, a spine surgeon performed surgery to relieve her low back and right leg pain, keeping her symptom-free for nearly three months. However, in the last 15 days, she developed sharp, radiating pain in her lower back that now affects both legs — highlighting the urgent need for effective L5-S1 Spine Infection Treatment.
Radiology Investigation :
MRI:
The MRI showed L5-S1 infective spondylodiscitis. The infection involved the intervertebral disc and nearby vertebrae. It also revealed retrolisthesis, where the L5 vertebra slipped backward over S1.
CT Scan (LS Spine – Plain):
The CT scan confirmed infective spondylodiscitis at L5-S1. It clearly showed the infection and spinal inflammation. Degenerative changes were also visible in the lumbar spine, including disc damage and possible bone changes.
X-ray Lumbosacral Spine (Flexion/Extension):
The X-ray revealed osteophytes (bone spurs) at LV3, LV4, and LV5, indicating chronic degeneration. It also showed reduced intervertebral space at LV5-S1, suggesting disc degeneration. During flexion, the X-ray confirmed retrolisthesis of LV5 over S1, proving instability in that spinal region.
These results point to both infection and degeneration, along with mechanical instability in the lower spine.
Operation :
Dr. Sangram Rajale performed L5-S1 posterior spinal instrumentation and posterolateral fusion under general anesthesia on December 14, 2021.
Implants Used:
Medtronic (Titanium)
This procedure aimed to stabilize the spine and treat both the infection and the degenerative changes at L5-S1.
Condition On Discharge :
The patient showed significant improvement right after surgery. Her severe back pain reduced considerably, allowing her to regain full mobility. She could walk, climb stairs, sit, and stand without discomfort. The sharp, radiating pain in both legs, especially the left, had subsided noticeably.
Doctors started her on long-term antibiotics to treat the spinal infection effectively. This therapy helped control the infection and prevented it from spreading. With the combination of surgery and antibiotics, her overall condition improved. She was discharged in stable health, with follow-up care planned to track her recovery and ensure the infection was fully resolved.