Saqui Abderrazzak El, Aggouri Mohamed, Benzagmout Mohamed, Chakour Khalid, Chaoui Mohamed El Faiz
Service Neurochirurgie, CHU Hassan II, Fès, Maroc.
Pan Afr Med J. 2017 Mar 14;26:145. doi: 10.11604/pamj.2017.26.145.9156. eCollection 2017.
The awareness about infections in the epidural space is increasing thanks to the development of neurosurgery, including MRI. Spinal epidural abscess is a rare pathology but extremely serious from a functional point of view and potentially life threatening. We report three cases of male patients (the first one aged 52 years, the second 57 years and the third 63 years) with diagnosed spinal epidural abscess. Two patients were admitted to the Neurosurgical Emergencies with slow progressive spinal cord compression evolving in the context of infection. The last patient complained of S1 sciatica pain in his right leg resistant to treatment associated with urinary incontinence. Entrance door of the infection wasn't identified during the initial assessment. All patients underwent spinal cord/radicular decompression surgery and evacuation of the epidural abscess via posterior approach. Bacteriological examination showed pyogenic germ justifying adequate prescription of antibiotic therapy in the three cases. The evolution was favorable in two cases. However one patient died three days after surgery due to severe sepsis.
由于神经外科的发展，包括磁共振成像（MRI）技术的进步，人们对硬膜外间隙感染的认识正在不断提高。脊柱硬膜外脓肿是一种罕见的病症，但从功能角度来看极其严重，甚至可能危及生命。我们报告了三例确诊为脊柱硬膜外脓肿的男性患者（第一例52岁，第二例57岁，第三例63岁）。其中两名患者因感染导致脊髓缓慢进行性受压而被收治入神经外科急诊。最后一名患者抱怨其右腿S1坐骨神经痛，治疗无效且伴有尿失禁。在初始评估期间未确定感染的入口途径。所有患者均接受了脊髓/神经根减压手术，并通过后路进行硬膜外脓肿引流。细菌学检查显示化脓性病菌，这证明三例患者均需进行适当的抗生素治疗。两例患者病情好转。然而，一名患者在术后三天因严重脓毒症死亡。
