Vertebral osteomyelitis following vertebroplasty: is acne a potential contraindication and are prophylactic antibiotics mandatory prior to vertebroplasty?

We present a case of vertebral osteomyelitis following vertebroplasty in a patient with acne of the back. Vertebral biopsy revealed Corynebacterium species and blood cultures were positive for Propionibacterium species. The patient did not respond to long-term intravenous antibiotics and required vertebral corpectomy and debridement with instrumentation. Interventionalists should be able to recognize acne of the back and consider this as a potential contraindication to vertebroplasty. Prophylactic antibiotics should be considered in all patients prior to vertebroplasty since subepidermal organisms are not eliminated with the standard skin prep.