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气体坏疽所致从颈椎至骶管的脊髓积气伴脊髓硬膜外脓肿

Pneumorachis from the cervical to the sacral spinal canal with spinal epidural abscess by gas gangrene.

作者信息

Matsuo Tomoki, Tanji Atsushi, Tateyama Koichi, Yoda Yuhei, Kamata Yusaku, Urabe Tadahisa

机构信息

Department of Orthopedic Surgery, Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan.

出版信息

J Orthop Surg (Hong Kong). 2019 May-Aug;27(2):2309499019860072. doi: 10.1177/2309499019860072.

Abstract

We present a 70-year-old woman with severe diabetes mellitus, who experienced low back pain and left lower leg paralysis. Computed tomography showed air in the spinal canal from C4 to S5, and magnetic resonance imaging revealed an epidural abscess from Th11 to L1. Laboratory findings showed increases in inflammatory indicators and blood culture indicated the presence of . The patient was treated conservatively with antibiotics. Neurological deficits and inflammatory data improved during the course. Follow-up imaging studies showed the disappearance of gas and epidural abscess. The existence of air in the spinal canal is a rare condition known as pneumorachis. To the best of our knowledge, such a long pneumorachis ranging from the cervical to the sacral spinal canal with epidural abscess caused by gas gangrene has not yet been described. We should therefore realize the possibility of epidural abscess produced by gas gangrene and treat it appropriately.

摘要

我们报告一名70岁患有严重糖尿病的女性,她经历了腰痛和左下肢瘫痪。计算机断层扫描显示从C4到S5的椎管内有气体,磁共振成像显示从胸11到腰1的硬膜外脓肿。实验室检查结果显示炎症指标升高,血培养表明存在……患者接受了抗生素保守治疗。病程中神经功能缺损和炎症数据有所改善。随访影像学研究显示气体和硬膜外脓肿消失。椎管内存在气体是一种罕见的情况,称为脊髓积气。据我们所知,尚未有因气性坏疽导致的从颈椎到骶椎椎管如此长的脊髓积气并伴有硬膜外脓肿的描述。因此,我们应该意识到气性坏疽导致硬膜外脓肿的可能性并进行适当治疗。

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