Andrews Edward G, Hect Jasmine L, Mittal Aditya M, Nowicki Kamil W, Agarwal Vikas, Gerszten Peter C
Departments of1Neurosurgery and.
2Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
J Neurosurg Case Lessons. 2023 Feb 6;5(6). doi: 10.3171/CASE22447.
Recent literature suggests that spinal infections are increasing in prevalence. Any compartment can be infected in the spine; however, multicompartmental infections are rare.
To the authors' knowledge, this report is the only reported case of a tetra-compartmental spinal infection consisting of epidural, subdural, subarachnoid, and intramedullary components with a contiguous lumbar spondylodiscitis resulting in conus medullaris syndrome requiring surgical intervention.
This case highlights the importance of surgical intervention in severe cases such as the one illustrated in this report. Second, magnetic resonance imaging with and without contrast is required to check for spreading of the infection as these findings may change the surgical approach. Last, the use of intraoperative ultrasound is paramount to evaluate the subdural and intramedullary compartments in severe cases.
近期文献表明脊柱感染的患病率正在上升。脊柱的任何腔室都可能被感染；然而，多腔室感染很少见。
据作者所知，本报告是唯一一例四腔室脊柱感染的报道病例，包括硬膜外、硬膜下、蛛网膜下和髓内成分，并伴有连续性腰椎椎体骨髓炎，导致圆锥马尾综合征，需要手术干预。
该病例凸显了在本报告所示的严重病例中进行手术干预的重要性。其次，需要进行有和没有造影剂的磁共振成像检查以查看感染的扩散情况，因为这些结果可能会改变手术方法。最后，在严重病例中使用术中超声对于评估硬膜下和髓内腔室至关重要。
