Infective Spondylodiscitis at L5-S1

A 65-year-old female presented with severe low back pain that had been progressively worsening over several weeks, resulting in significant difficulty in ambulation and restriction of daily activities. Clinically, she exhibited localized tenderness in the lumbosacral region with painful spinal movements. Her condition raised strong suspicion of an underlying spinal infection. Subsequent laboratory investigations revealed elevated inflammatory markers, supporting an infective etiology.

Imaging studies, including MRI and plain X-rays, confirmed the presence of spondylodiscitis at the L5-S1 level, characterized by destruction of the vertebral end plates and narrowing of the intervertebral disc space. There were also early signs of instability at the lumbosacral junction. The progressive bony destruction was concerning, as it posed risks of persistent pain, deformity, and potential neurological compromise if left untreated. The combination of advanced age, severe functional disability, and the destructive changes necessitated surgical management. A plan for posterior instrumentation with stabilization, debridement, and bone grafting was made to control infection, restore stability, and promote fusion.