Okada Fumiharu, Takayama Hiroyuki, Doita Minoru, Harada Toshihiko, Yoshiya Shinichi, Kurosaka Masahiro
Department of Orthopaedic Surgery, Hyogo Prefectural Kakogawa Hospital, Hyogo, Japan.
J Spinal Disord Tech. 2005 Oct;18(5):458-61. doi: 10.1097/01.bsd.0000159036.42989.93.
A case of lumbar facet joint infection associated with epidural and paraspinal abscess is presented. A 57-year-old man was hospitalized with severe low back pain that radiated into the bilateral buttocks and legs. The patient had a temperature of 37.3 degrees C, and the biochemical inflammatory parameters were elevated. Initially on admission, we administered antibiotics intravenously. However, pain increased, fever elevated gradually, and bladder-bowel disturbance appeared. Magnetic resonance imaging (MRI) showed effusion in the widened facet joint, paraspinal muscles, and epidural space, which compressed the theca severely. We performed an immediate surgical debridement combined with thorough antibiotic therapy and achieved excellent results. MRI was useful for precise diagnosis and operative planning.
本文报告一例与硬膜外及椎旁脓肿相关的腰椎小关节感染病例。一名57岁男性因严重的下背部疼痛入院，疼痛放射至双侧臀部及腿部。患者体温37.3摄氏度，生化炎症指标升高。入院初期，我们静脉给予抗生素治疗。然而，疼痛加剧，体温逐渐升高，并出现膀胱直肠功能障碍。磁共振成像（MRI）显示增宽的小关节、椎旁肌肉及硬膜外间隙有积液，严重压迫了硬膜囊。我们立即进行了手术清创，并联合彻底的抗生素治疗，取得了良好效果。MRI有助于精确诊断和手术规划。
