Daglioglu Ergun, Bayazit N, Okay O, Dalgic A, Hatipoglu H G, Ergungor F
Neurosurgery clinics, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Neurocirugia (Astur). 2009 Apr;20(2):159-62. doi: 10.1016/s1130-1473(09)70183-6.
Spinal epidural abscess due to Brucella species is usually associated with spondylodiscitis. Urgent surgical decompression should be performed in cases with moderate to severe neurological deficits particularly if progressive. We report clinical features of two cases operated for lumbar epidural abscess caused by Brucella species. Early surgical decompression combined with medical treatment could decrease progression of neurological findings or the severity of complications. Iatrogenic dural tear at the operation should be repaired immediately with fine sutures and fibrin tissue glue to prevent further innoculation into the cerebrospinal axis. These cases should be cautiously followed for any recurrence or neurobrucellosis.
布鲁氏菌属引起的脊柱硬膜外脓肿通常与脊椎椎间盘炎相关。对于有中度至重度神经功能缺损的病例，尤其是病情进展的情况，应进行紧急手术减压。我们报告了两例因布鲁氏菌属导致腰椎硬膜外脓肿而接受手术的临床特征。早期手术减压联合药物治疗可减少神经功能症状的进展或并发症的严重程度。手术中发生的医源性硬脑膜撕裂应立即用细缝线和纤维蛋白组织胶修复，以防止进一步感染至脑脊液系统。应对这些病例进行密切随访，观察有无复发或神经型布鲁氏菌病。
