Gleeson Joseph J, Berg Andrew J, Loughenbury Peter R, Selvanathan Senthil K, Leung Andraay
Spinal Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, GBR.
Cureus. 2021 Mar 4;13(3):e13703. doi: 10.7759/cureus.13703.
Pyogenic subdural spinal collections are rare but an important pathology to recognise and manage appropriately. We report the case of a 56-year-old female who developed a posterior subdural spinal collection associated with local discitis. There was no direct communication between the infected disc and subdural space, and the collection was located posteriorly within the subdural space which makes this case all the more unusual. We discuss the need for spinal subdural collections to be considered as a differential in patients with back pain and lower limb neurology (especially when there is a known spinal infective focus), the importance of careful interpretation of imaging, and the pathophysiological mechanisms and organisms known to cause spinal subdural collections.
化脓性硬脊膜下脊髓积脓罕见，但却是一种需要识别并妥善处理的重要病理情况。我们报告一例56岁女性病例，该患者出现了与局部椎间盘炎相关的硬脊膜下脊髓后间隙积脓。感染的椎间盘与硬脊膜下间隙之间没有直接连通，且积脓位于硬脊膜下间隙后方，这使得该病例更为特殊。我们讨论了对于背痛和下肢神经功能障碍患者（尤其是存在已知脊柱感染病灶时），需要将硬脊膜下脊髓积脓纳入鉴别诊断的必要性、仔细解读影像学检查结果的重要性，以及已知可导致硬脊膜下脊髓积脓的病理生理机制和病原体。
