Proietti Luca, Ricciardi Luca, Noia Giovanni, Barone Giuseppe, Valenzi Eugenio, Perna Andrea, Giannelli Ilaria, Scaramuzzo Laura, Visocchi Massimiliano, Papacci Fabio, Tamburrelli Francesco Ciro
Spine Surgery Division, Agostino Gemelli Hospital, Catholic University of the Sacred Heart of Rome, Rome, Italy.
Institute of Neurological Surgery, Catholic University of the Sacred Heart of Rome, Agostino Gemelli Hospital, Rome, Italy.
Acta Neurochir Suppl. 2019;125:345-353. doi: 10.1007/978-3-319-62515-7_50.
An extensive spinal epidural abscess is a rare condition and causes significant morbidity and mortality. Few authors have described this uncommon entity, which requires early diagnosis and optimal treatment to avoid devastating complications. The purpose of this study was to evaluate a minimally invasive technique for treatment of an extensive spinal epidural abscess by describing two cases. Furthermore, we conducted a review of the recent literature on the management of this rare condition.
We report two cases of spinal abscesses extending to the whole epidural space, successfully treated by use of a minimally invasive technique consisting of multilevel laminotomy and catheter irrigation to decompress and drain the epidural space.
This technique is able to decompress the spinal cord, isolate the pathogen and evacuate the abscess. No complications, late spine deformity or dura penetration were observed in our patients.
Urgent surgical decompression, in combination with long-term antibiotic treatment, is generally considered the treatment of choice for an extensive spinal epidural abscess. A minimally invasive technique can be very useful as a surgical option.
广泛的脊柱硬膜外脓肿是一种罕见疾病，会导致严重的发病率和死亡率。很少有作者描述过这种不常见的病症，其需要早期诊断和最佳治疗以避免毁灭性并发症。本研究的目的是通过描述两例病例来评估一种治疗广泛脊柱硬膜外脓肿的微创技术。此外，我们对近期关于这种罕见病症治疗的文献进行了综述。
我们报告两例脊柱脓肿延伸至整个硬膜外间隙的病例，通过采用包括多级椎板切开术和导管冲洗以减压和引流硬膜外间隙的微创技术成功治疗。
该技术能够使脊髓减压、分离病原体并排出脓肿。我们的患者未观察到并发症、晚期脊柱畸形或硬膜穿透。
紧急手术减压联合长期抗生素治疗通常被认为是广泛脊柱硬膜外脓肿的首选治疗方法。微创技术作为一种手术选择可能非常有用。
