Adil Aziz, Waseem Khan, Sadia Khan, Sameen Shoaib.
Paraspinal abscess with epidural extension, after an antiinflammatory non steroidal injection, in the gluteal region.
Pak J Surg Jan ;28(1):85-7.

Spinal epidural abscess is a collection of suppurative material that forms between the dura mater and the ligamentum fl avum. If not recognized early and treated correctly, it can lead to life-threatening sepsis. We are presenting a case of a 17 year old male with history of low backache for last 3 months for which he received right intragluteal injection by a quack in his village .Patient started to develop weakness of the lower limbs aft er the intragluteal injection. Examination revealed paraparesis of the lower limbs. CT scan lumbosacral spine and pelvis with contrast showed a right lower paraspinal mass with intraspinal extensions through the Rt L5/S1 neural foramen. Inferiorly the extradural component was seen exiting from the right S1 neural foramen which was also minimally expanded.On MRI lumbosacral spine, a large lobulated lesion surrounding the body and right transverse process of L5 and S1 vertebrae .Th e lesion was isointense to muscles on T1WS and homogeneously hyperintense on T2WS. Psoas mass and sacral mass biopsy revealed it to be an abscess and pus was drained. Aft er the treatment patient was pain free and gradually power improved in the lower limbs and he was able to walk without support.

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