University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis.
St. George's University, St. George, Grenada.
World Neurosurg. 2023 Jun;174:205-212.e6. doi: 10.1016/j.wneu.2023.03.013. Epub 2023 Mar 9.
Intramedullary spinal cord abscess (ISCA) is an extremely rare disease, which has had fewer than 250 reported cases since its initial description in 1830. The condition is limited to level V evidence, limiting the ability for surgeons to characterize and treat it.
To report the cases of 2 patients with ISCA and their surgical management: a 59-year-old woman who presented with progressive right hemiparesis and a 69-old man who presented with acute gait instability and significant bilateral shoulder pain. In addition, to report findings from a systematic literature review and associated logistic regression analysis.
A MEDLINE and Embase search was conducted using the keywords "intramedullary," "spinal cord," "abscess," and "tuberculoma" and the results were screened for case reports. A logistic regression model was fit 100 times on data to retrieve predictor odds ratios.
Two hundred case reports of ISCA were identified between 1965 and 2022. Logistic regression determined that the only variables of significance were age (P < 0.01) and antibiotics (P < 0.05).
Treatment of ISCAs has significantly improved over the years. However, ISCAs are still poorly understood. Our recommendations can be used to guide diagnosis and treatment.
椎管内脊髓脓肿（ISCA）是一种极为罕见的疾病，自 1830 年首次描述以来，报告的病例少于 250 例。该疾病的证据级别为 V 级，限制了外科医生对其进行特征描述和治疗的能力。
报告 2 例 ISCA 患者及其手术治疗情况：1 例 59 岁女性，表现为进行性右侧偏瘫；1 例 69 岁男性，表现为急性步态不稳和明显双侧肩部疼痛。此外，还报告了系统文献回顾和相关逻辑回归分析的结果。
使用“intramedullary”、“spinal cord”、“abscess”和“tuberculoma”等关键词在 MEDLINE 和 Embase 上进行了搜索，并对病例报告进行了筛选。使用逻辑回归模型对 100 次数据进行拟合，以获取预测因子的比值比。
1965 年至 2022 年间共发现 200 例 ISCA 病例。逻辑回归确定唯一有意义的变量是年龄（P < 0.01）和抗生素（P < 0.05）。
近年来，ISCA 的治疗有了显著改善。然而，ISCA 仍然知之甚少。我们的建议可用于指导诊断和治疗。
