Feldenzer J A, McKeever P E, Schaberg D R, Campbell J A, Hoff J T
Neurosurgery. 1987 Jun;20(6):859-67. doi: 10.1227/00006123-198706000-00007.
To define the pathophysiology of spinal cord dysfunction associated with spinal epidural abscess formation, we developed an experimental model. Spinal epidural abscesses were produced in rabbits by injecting Staphylococcus aureus into the posterior thoracolumbar epidural space under direct vision. Progressive neurological deficits were detected in 18 of 20 animals; severe paraparesis or paraplegia occurred in 75%, and sphincter dysfunction occurred in 55%. Clinical data, including the results of plain spine roentgenography, myelography, and biochemical and bacteriological examination of the cerebrospinal fluid, were recorded. Epidural abscesses with varying degrees of spinal cord compression were confirmed pathologically in 95% of the experimental group. Spinal cord white matter changes included vacuolization, loss of myelin, and axonal swelling. The gray matter of the spinal cords was relatively preserved. There was no microscopic evidence of thrombosis or vasculitis in the major blood vessels supplying the spinal cords. Histopathological changes detected in the spinal cords were more consistent with direct compression of neural tissue than with infarction. The progressive clinical course and the histopathological changes in the spinal cord after compression by abscess closely resembled those of experimental compression of the spinal cord by epidural neoplasm.
为了明确与脊髓硬膜外脓肿形成相关的脊髓功能障碍的病理生理学，我们建立了一个实验模型。通过在直视下将金黄色葡萄球菌注入兔胸腰段后硬膜外间隙，制造脊髓硬膜外脓肿。20只动物中有18只出现进行性神经功能缺损；75%出现严重的下肢轻瘫或截瘫，55%出现括约肌功能障碍。记录临床数据，包括脊柱X线平片、脊髓造影以及脑脊液生化和细菌学检查结果。95%的实验组经病理证实存在不同程度脊髓压迫的硬膜外脓肿。脊髓白质改变包括空泡化、髓鞘丧失和轴突肿胀。脊髓灰质相对保留。在供应脊髓的主要血管中没有显微镜下血栓形成或血管炎的证据。在脊髓中检测到的组织病理学变化与神经组织的直接压迫比与梗死更一致。脓肿压迫后脊髓的进行性临床过程和组织病理学变化与硬膜外肿瘤对脊髓的实验性压迫非常相似。
