Lumbosacral spondylodiscitis: an unusual complication of abdominal sacrocolpopexy

Abstract

Lumbosacral spondylodiscitis, an unusual complication of abdominal sacrocolpopexy using synthetic polypropylene mesh is reported. A young sexually active female with stage IV pelvic organ prolapse was managed with abdominal hysterectomy and sacrocolpopexy. Cervical dysplasia demanded hysterectomy and sacrocolpopexy was done to achieve good long-term results. Mesh exposure was noticed in the early post-operative period which initially responded to conservative management. Eight weeks later, the patient reported with severe pain in lower back restricting her physical movements and ambulation. Further evaluation with magnetic resonance imaging (MRI) confirmed lumbosacral spondylodiscitis, due to the infected mesh which warranted a complete removal of mesh by laparotomy. Removal of the mesh completely relieved her symptoms. Repeat MRI revealed resolving spondylodiscitis. The removal of mesh by itself was adequate to relieve her and discectomy was not required. The vault remained well supported despite removal of mesh.