Pyogenic lumbar facet joint arthritis with intradural extension: a case report.

There have been 40 previously reported cases of lumbar facet joint pyogenic infection. These have been well characterized earlier. Intradural pyogenic extension has never been reported from a facet joint origin. This case demonstrates an elderly diabetic man with acute onset of nontraumatic back pain with no other source of infectious pathology. Surgical exploration identified a purulent left L4-L5 facet joint with epidural and intradural extension. Minimal spinal fluid leak was present. Wound cultures were positive for Group B beta Streptococcus. Full resolution occurred with appropriate intravenous vancomycin antibiotic therapy.