Department of Neurosurgery, Abant Izzet Baysal University, Bolu, Turkey.
J Korean Med Sci. 2010 Jan;25(1):176-9. doi: 10.3346/jkms.2010.25.1.176. Epub 2009 Dec 26.
Despite advances in neuroimaging and neurosurgical treatment modalities, spinal epidural abscess remains a challenging problem. Early diagnosis is often difficult and treatment is always delayed. Spinal epidural abscess usually develops in patients with predisposing factors such as IV drug abuse, senillity, diabetes mellitus, spinal attempts, alcoholism, immunosuppression, liver diseases and catheterizations. It is rarely seen in cervical region. A successful treatment is only possible with early diagnosis and accurate surgical and medical treatment. Optimal management is unclear and morbidity and mortality are significant. We present two adult haemodialysis patients with end-stage renal insufficiency who developed cervical epidural abscess following central venous catheter placement. Early surgical intervention is mandatory in cases those have progressive neurological deficit and spinal deformity, and this is also increases the success rate of medical therapy.
尽管神经影像学和神经外科治疗方法取得了进展,但脊髓硬膜外脓肿仍然是一个具有挑战性的问题。早期诊断通常很困难,治疗总是会被延误。脊髓硬膜外脓肿通常发生在有易患因素的患者中,如静脉内药物滥用、衰老、糖尿病、脊柱尝试、酗酒、免疫抑制、肝病和导管插入术。它在颈椎区域很少见。只有早期诊断和准确的手术及药物治疗才能取得成功。最佳治疗方法尚不清楚,发病率和死亡率都很高。我们介绍了 2 例终末期肾功能不全的血液透析成年患者,他们在中心静脉置管后发生了颈椎硬膜外脓肿。对于那些有进行性神经功能缺损和脊柱畸形的病例,早期手术干预是必需的,这也增加了药物治疗的成功率。