广泛硬膜外脓肿的手术治疗及长期随访
Extensive epidural abscess with surgical treatment and long term follow up.
作者信息
Urrutia Julio, Rojas Claudio
机构信息
Department of Orthopaedic Surgery, Pontificia Universidad Catolica de Chile, Marcoleta 352, Santiago, Region Metropolitana, Chile.
出版信息
Spine J. 2007 Nov-Dec;7(6):708-11. doi: 10.1016/j.spinee.2006.08.012. Epub 2006 Dec 22.
BACKGROUND CONTEXT
Spinal epidural abscess is an uncommon infection. There are few reports on extensive epidural abscesses.
PURPOSE
We report a case of an epidural abscess extending from C2 to the sacrum, with a long-term follow-up.
STUDY DESIGN
A case report of an extensive epidural abscess with surgical treatment.
METHODS
A 36-year-old male patient presented with a history of 15 days of fever and severe lumbar and neck pain. Magnetic resonance imaging disclosed an epidural abscess extending from C2 to the sacrum. Limited laminectomies were performed in the cervical, thoracic, and lumbar spine, and pus was obtained. A peptostreptococus grew in cultures. The patient received 6 weeks of antibiotics.
RESULTS
The infection was successfully treated, and no neurological deficit was observed. The patient continued asymptomatic 5 years after surgery, and no deformity has developed.
CONCLUSIONS
A case of an extensive epidural abscess was successfully treated with limited laminectomies and antibiotics. This less invasive technique could treat the infection, and no late deformity has been observed.
背景
脊柱硬膜外脓肿是一种罕见的感染。关于广泛硬膜外脓肿的报道很少。
目的
我们报告一例从C2延伸至骶骨的硬膜外脓肿病例，并进行长期随访。
研究设计
一例广泛硬膜外脓肿手术治疗的病例报告。
方法
一名36岁男性患者，有15天发热及严重腰颈部疼痛病史。磁共振成像显示硬膜外脓肿从C2延伸至骶骨。在颈椎、胸椎和腰椎进行了有限的椎板切除术，并获取了脓液。培养物中生长出消化链球菌。患者接受了6周的抗生素治疗。
结果
感染得到成功治疗，未观察到神经功能缺损。患者术后5年无症状，未出现畸形。
结论
一例广泛硬膜外脓肿通过有限的椎板切除术和抗生素成功治疗。这种侵入性较小的技术可以治疗感染，且未观察到晚期畸形。
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