Bakhsheshian Joshua, Kim Paul E, Attenello Frank J
Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
World Neurosurg. 2017 Oct;106:1049.e1-1049.e2. doi: 10.1016/j.wneu.2017.06.121. Epub 2017 Jul 5.
Intramedullary spinal cord abscesses are rarely encountered in modern neurosurgical practice. Select patients are at high risk for developing an intramedullary spinal cord abscess, which can result in acute neurologic deficits. Patients with failed conservative management may benefit from early surgical intervention; however, the evidence is limited by level 3 studies. In this case presentation, the patient failed conservative management for a cervical intramedullary spinal cord abscess and developed acute neurologic deficits. The decision was made to perform an urgent cervical laminectomy and drainage to avoid any further decline that may have occurred with continued conservative management. Increased awareness of intramedullary spinal cord abscess is warranted for its clinical suspicion and emergent treatment in select circumstances.
髓内脊髓脓肿在现代神经外科实践中很少见。特定患者发生髓内脊髓脓肿的风险较高,这可能导致急性神经功能缺损。保守治疗失败的患者可能从早期手术干预中获益;然而,三级研究的证据有限。在本病例报告中,患者因颈髓内脊髓脓肿保守治疗失败并出现急性神经功能缺损。决定进行紧急颈椎椎板切除术和引流,以避免继续保守治疗可能出现的任何进一步病情恶化。对于髓内脊髓脓肿,在特定情况下提高其临床怀疑意识并进行紧急治疗是必要的。