Mustafa R. Dodurgali, MD
Resident Physician
Yale School of Medicine
New Haven, Connecticut, United States
Charles A. Odonkor, MD
Assistant Professor of Orthopaedics & Rehabilitation
Yale School of Medicine
New Haven, Connecticut, United States
Cultibacterium acnes is a gram-positive anaerobic bacterium commonly found in the skin flora. While typically non-virulent, it can become pathogenic following spinal surgeries. Patients who experience persistent low back pain after what initially appears to be a successful spinal fusion may face significant diagnostic challenges. Despite trying various pain management techniques, these patients often do not achieve lasting relief. One major obstacle to accurate diagnosis is that imaging studies typically reveal nonspecific findings that do not clearly indicate the presence of an infection. Cultibacterium acnes is especially insidious because it is slow-growing and does not usually produce the classic signs of infection, such as fever or drainage. Delay in diagnosis causes prolonged patient discomfort and ineffective treatment until the underlying cause is identified and addressed.
Conclusions: Cultibacterium acnes is a potential cause of persistent pain following spinal fusion surgery. This case highlights the necessity for clinicians to have a high index of suspicion when treating patients with a history of post-spinal fusion pain. Early identification of this pathogen is critical, as delayed diagnosis can lead to long-term patient discomfort and complications.
