Oktenoglu Tunc, Sasani Mehdi, Cetin Birsen, Bozkus Hakan, Ercelen Omur, Vural Metin, Ozer Ali Fahir, Sarioglu Ali Cetin
American Hospital, Department of Neurosurgery, Istanbul, Turkey.
Turk Neurosurg. 2011 Jan;21(1):74-82.
Spontaneous pyogenic spinal epidural abscess (SEA) is a rare condition but might be devastating and fatal. Traditional treatment is surgical decompression and antibiotics. A retrospective study was designed to assess the eff ect of clinical findings and treatment methods on the outcome.
14 patients were reviewed (10 male, 4 female, mean age 59.14). Six dorsal, seven ventral and one dorsal with ventral SEA were observed. SEA found in thoracal (5), lumbar (4), cervical (3) regions. One patient showed both cervical and thoracal and one patient showed cervical, thoracal and lumbar involvement. All patients received minimum 3 weeks of I.V., followed by minimum 3 weeks of oral antibiotics. All patients complained of spinal pain. Ten patients presented with fever. Neurological deficit was observed in 9 cases.
A total of 22 interventions was performed. Instrumentation was applied in 5 cases. Full recovery was achieved in 7 patients, significant improvement was observed in 5 patients. The neurological findings did not change in one patient. One mortality and one morbidity were observed.
Spontaneous SEA is a rare disease but might result in catastrophic neurological deficits and fatal even with prompt treatment. Therefore, one should always keep SEA in mind if a patient presents with fever, vague and spinal pain.
自发性化脓性脊柱硬膜外脓肿（SEA）是一种罕见疾病，但可能具有毁灭性且可致命。传统治疗方法是手术减压和使用抗生素。一项回顾性研究旨在评估临床发现和治疗方法对预后的影响。
对14例患者进行了回顾性分析（男性10例，女性4例，平均年龄59.14岁）。观察到6例为背侧SEA，7例为腹侧SEA，1例为背侧合并腹侧SEA。SEA见于胸段（5例）、腰段（4例）、颈段（3例）。1例患者颈段和胸段均受累，1例患者颈段、胸段和腰段均受累。所有患者静脉使用抗生素至少3周，随后口服抗生素至少3周。所有患者均主诉有脊柱疼痛。10例患者出现发热。9例患者观察到神经功能缺损。
共进行了22次干预措施。5例患者应用了内固定。7例患者完全康复，5例患者有显著改善。1例患者神经功能表现未改变。观察到1例死亡和1例发病。
自发性SEA是一种罕见疾病，但即使及时治疗也可能导致灾难性的神经功能缺损甚至死亡。因此，如果患者出现发热、不明原因的脊柱疼痛，应始终考虑到SEA。
