Ahluwalia R, Scherer A
Florida State College of Medicine, 250 E Colonial Dr #200, Orlando, FL, 32801, USA.
Department of Neurological Surgery, Nemours Children's Hospital, Orlando, FL, USA.
Childs Nerv Syst. 2019 Jul;35(7):1109-1115. doi: 10.1007/s00381-019-04143-x. Epub 2019 Apr 13.
The purpose of this study was to review a case comprised of a cervical spinal epidural abscess, cervical and thoracic paraspinous edema, and widening of the right thoracic neural foramen secondary to a phlegmon.
We reviewed the case of a spinal epidural abscess managed medically in a 4-year-old male and performed a review of the literature with 15 other cases that have previously been reported.
The current mainstay of treatment is largely variant but generally falls into a laminectomy-based surgical approach or longstanding antibiotics. Our review of the literature concluded that there are currently no clear guidelines established to recommend treatment, and current practice is largely based on the discretion of the pediatric neurosurgeon.
Based on the literature review, and our personal case illustration, we conclude that an antibiotic-based treatment is a valid approach for therapy if initiated promptly in a pediatric patient with no neurological deficit.
本研究旨在回顾一例由颈段脊髓硬膜外脓肿、颈胸段椎旁水肿以及因蜂窝织炎导致的右侧胸段神经孔增宽组成的病例。
我们回顾了一名4岁男性接受保守治疗的脊髓硬膜外脓肿病例，并对先前报道的其他15例病例进行了文献复习。
目前的主要治疗方法差异很大，但总体上分为基于椎板切除术的手术方法或长期使用抗生素。我们的文献复习得出结论，目前尚无明确的治疗推荐指南，当前的治疗实践很大程度上取决于儿科神经外科医生的判断。
基于文献复习和我们的个人病例说明，我们得出结论，如果在没有神经功能缺损的儿科患者中及时开始治疗，基于抗生素的治疗是一种有效的治疗方法。
