Acute Panspinal Epidural Abscess.
- Author:
Heon KIM
1
;
Seong Hoon OH
;
Il Seung CHOI
;
Kwang Hum BAK
;
Young Soo KIM
;
Choong Hyun KIM
;
Young KO
;
Suck Jun OH
;
Kwang Myung KIM
;
Nam Kyu KIM
;
Woong Hwan CHOI
Author Information
1. Department of Neurosurgery, College of Medicine, Hanyang University, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Spinal epidural abscess;
Laminectomy;
Drainage;
MRI
- MeSH:
Abscess;
Back Pain;
Decompression;
Decompression, Surgical;
Diagnosis;
Drainage;
Epidural Abscess*;
Epidural Space;
Fibrosis;
Furunculosis;
Granulation Tissue;
Humans;
Laminectomy;
Magnetic Resonance Imaging;
Neck;
Skin;
Spinal Cord;
Spine;
Staphylococcus;
Thrombosis;
Vasculitis
- From:Journal of Korean Neurosurgical Society
1999;28(3):392-397
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Epidural abscess of the spine is an uncommon disorder. However, this condition can cause irriversible neurologic injury or death if it is not recognized and treated early. The constellation of presenting symptoms is frequently nondiagnostic and may be especially confusing in patients with chronic neck or back pain. The most important source of infection is, via hematogenous spread, the furuncle and abscess of the skin. The most frequent site of infection is thoracolumbar region(50%), and the most common cause of pathogen is Staphylococcus The pathogenesis o f the associated spinal cord dysfunction remains unresolved, but histopathological data from a previous study suggested that a mechanical mass effect rather than vascular thrombosis or vasculitis was responsible for the initial neurological deficit. MRI offered the advantage of noninvasive early recognition and anatomical localization, which made it the imaging modality of choice. Rim enhancement indicates abscess and diffuse enhancement indicates granulation tissue and fibrosis. Tuberculous epidural abscess usually spreads to ventral epidural space whereas pyogenic epidural abscess encircles entire epidural space. The treatment of choice of the spinal epidural abscess is early surgical decompression and drainage. Rapid diagnosis and treatment of this disease is essential for neurologic recovery and even for preservation of life. The author report a case of spinal epidu ral abscess, which involved continuously from the second cervical vertebra to the forth lumbar vertebra. The patients neurological conditions were improved following emergent decompression.
