Kobayashi T, Okamura K, Sugiura M, Nakane M, Iida M
No Shinkei Geka. 1975 Aug;3(8):697-702.
Acute spinal epidural abscess is found to be relatively rare and may be getting rarer since antibiotics have been widely used. An early diagnosis and prompt surgical treatment are still important to prevent severe neurological deficit such as paraplegia. A characteristic case is presented. Eighteen years old boy showed acute progression of paraplegia and rectourinary difficulty with complete spinal block at T 6-7 intervertebral space on myelography, who had suffered from multiple infectious lacerations on his face and hands two months previously. There was complete recovery of neurological signs following removal of epidural abscess with granulation tissue and spinal decompression by lamineotomy through T 5-7, and supplimentary antibiotic therapy for the organism (Staphylococcus aureus). To our knowlodge, this will be the first case report in this country, which has been obtained successful recovery after surgical treatment in such an acute case.
急性脊髓硬膜外脓肿相对少见,且由于抗生素的广泛使用,其发病率可能正变得更低。早期诊断和及时的手术治疗对于预防诸如截瘫等严重神经功能缺损仍然很重要。本文介绍了一个典型病例。一名18岁男孩出现截瘫急性进展及直肠泌尿功能障碍,脊髓造影显示T6 - 7椎间隙完全性脊髓阻滞,该男孩两个月前面部和手部曾有多处感染性裂伤。通过T5 - 7椎板切除术清除硬膜外脓肿及肉芽组织并进行脊髓减压,同时针对病原体(金黄色葡萄球菌)进行辅助抗生素治疗后,神经体征完全恢复。据我们所知,这将是该国首例此类急性病例经手术治疗后成功康复的病例报告。