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胸椎管硬膜外脓肿患者的急诊手术:病例报告及文献复习。

Emergency surgery for a patient with a thoracic spinal epidural abscess: a case report and literature review.

机构信息

Department of Orthopedics, Jiande Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, China.

Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

J Int Med Res. 2023 Apr;51(4):3000605231168757. doi: 10.1177/03000605231168757.

Abstract

A man in his early 40s visited the Emergency Department because of no motor function in his lower limbs for 10 hours. Magnetic resonance imaging of his thoracic spine showed that the thoracic spinal canal (T2-T6) was occupied, and the thoracic spinal cord was compressed. In view of the severe symptoms, we quickly completed preoperative preparations and performed a thoracic laminectomy within 24 hours of paralysis of both lower limbs. Postoperatively, the patient underwent rehabilitation exercise. Four weeks later, the patient's lower limbs had full 5/5 strength. We reviewed the related literature to summarize the clinical guidelines with spinal surgeons. Timely diagnosis of thoracic spinal epidural abscess, early surgical treatment, and anti-infection management and rehabilitation exercise are essential for the full recovery of lower limb muscle strength.

摘要

一位 40 岁出头的男性因下肢 10 小时无运动功能而到急诊科就诊。他的胸椎磁共振成像显示胸椎椎管(T2-T6)被占据,胸椎脊髓受压。鉴于症状严重,我们迅速完成了术前准备,并在双下肢瘫痪后 24 小时内进行了胸椎椎板切除术。术后,患者接受了康复锻炼。四周后,患者的下肢肌力达到 5/5 级。我们查阅了相关文献,与脊柱外科医生一起总结了临床指南。及时诊断胸椎管硬膜外脓肿,早期手术治疗,抗感染管理和康复锻炼对于下肢肌力的完全恢复至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62c9/10131533/48597ab5d1ce/10.1177_03000605231168757-fig1.jpg

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