Severe lower back pain

Four months after having a right-sided L3-L4 diskectomy, a 65-year-old man with severe lower back pain visited the emergency room. The discomfort from the operation never went away, and it seems to be worsening fromthe past three to four weeks. His previous lumbar incision is nicely healed and shows no symptoms of infection upon physical examination. He also has no neurological impairments in the lower extremity. Staphylococcus aureus was detected in the emergency department's blood cultures. Bone marrow oedema at the L3 and L4 vertebral bodies and fluid signal in the intervertebral region on magnetic resonance imaging of the lumbar spine are consistent with acute diskitis-osteomyelitis in this case (Figure).