Williams did not have that problem in Salt Lake City as five of his teammates joined him in double figures.
Mehmet Okur had 18 points and 11 rebounds, Kirilenko blocked five shots and scored 15 points and Carlos Boozer contributed 14 points and 12 rebounds.
Kyle Korver also had 14 points and Matt Harpring added 12 as Utah opened the overtime session with a 9-2 run to take control.
Bryant had five of his team's seven points in overtime, but was slowed by the back spasms, which allowed Kirilenko to block a pair of his shots.
"I was angry at his teammates for dropping the ball in his lap," Lakers coach Phil Jackson said.
"I felt guys just bailed out on him."
Derek Fisher scored 10 consecutive Los Angeles points to spark a fourth-quarter comeback. He finished with 15.
Lamar Odom, who had 26 points, sent the game into overtime on a tip-in with four seconds remaining in regulation and Pau Gasol added 23 points.
Lakers' forward-center Ronny Turiaf had two flagrant fouls called on him in the second quarter and was ejected from the game after a hard foul on Utah's Ronnie Price.
Price needed several stitches to close a cut about his right eye.
Game 5 is in Los Angeles on Thursday.
In San Antonio, the Hornets' David West had three blocks but was held to 10 points on 4-of-15 shooting and was visibly frustrated. Reserve Jannero Pargo scored 11 for the visitors.
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