Rauchwerger Jacob J, Zoarski Gregg H, Waghmarae Romanth, Rabinowitz Ronald P, Kent Joel L, Aldrich Enslin F, Closson Carey Walter F
Department of Anesthesiology/Division of Pain Management, University of Maryland Medical Center, Baltimore, Maryland, USA.
Pain Pract. 2008 Jul-Aug;8(4):324-8. doi: 10.1111/j.1533-2500.2008.00206.x. Epub 2008 May 23.
Spinal cord stimulation is increasingly utilized as a treatment to alleviate low back pain and lumbar radiculopathy, particularly in patients with failed back surgery syndrome. We present an illustrative case of early, rapidly progressive methicillin-resistant Staphylococcus aureus (MRSA) infection after a brief stimulator trial lead implantation. Operators should maintain a high level of suspicion for deep infection, including epidural abscess, even when only minor symptoms and signs are present. Because of the poor ability to clear infections in the presence of a retained foreign body, the device must be explanted immediately. Subsequent surgical intervention, however, may nevertheless still be needed. While a variety of bacteria may cause epidural abscess, methicillin sensitive Staphylococcus aureus, and increasingly, MRSA and community-associated MRSA, are the most likely etiologic organisms.
脊髓刺激越来越多地被用作缓解腰痛和腰椎神经根病的一种治疗方法，特别是对于腰椎手术失败综合征患者。我们展示了一个在短暂的刺激器试验电极植入后早期、快速进展的耐甲氧西林金黄色葡萄球菌（MRSA）感染的典型病例。即使仅存在轻微的症状和体征，操作者也应高度怀疑深部感染，包括硬膜外脓肿。由于存在异物残留时清除感染的能力较差，必须立即取出装置。然而，后续可能仍需要进行手术干预。虽然多种细菌可能导致硬膜外脓肿，但甲氧西林敏感金黄色葡萄球菌，以及越来越多的MRSA和社区获得性MRSA，是最可能的病原体。
