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颈椎硬膜外脓肿:诊断、治疗及预后:病例系列报告与文献综述

Cervical Spinal Epidural Abscess: Diagnosis, Treatment, and Outcomes: A Case Series and a Literature Review.

作者信息

Papadakis Stamatios A, Ampadiotaki Margarita-Michaela, Pallis Dimitrios, Tsivelekas Konstantinos, Nikolakakos Petros, Agapitou Labrini, Sapkas George

机构信息

B' Orthopaedic Department, KAT General Hospital of Attica, 14561 Kifissia, Greece.

Orthopaedic Department, Metropolitan Hospital, 18547 Athens, Greece.

出版信息

J Clin Med. 2023 Jul 5;12(13):4509. doi: 10.3390/jcm12134509.

Abstract

Although recent diagnostic and management methods have improved the prognosis of cervical epidural abscesses, morbidity and mortality remain significant. The purpose of our study is to define the clinical presentation of cervical spinal epidural abscess, to determine the early clinical outcome of surgical treatment, and to identify the most effective diagnostic and treatment approaches. Additionally, we analyzed studies regarding cervical epidural abscesses and performed a review of the literature. In this study, four patients with spinal epidural abscess were included. There were three men and one woman with a mean age of 53 years. Three patients presented with motor deficits, and one patient was diagnosed incidentally through spinal imaging. All the patients had fever, and blood cultures were positive. Staphylococcus aureus was the most common organism cultured from abscesses. All patients underwent a surgical procedure, and three patients recovered their normal neurological functions, but one remained with mild neurological disability that was resolved two years postoperatively. The mean follow-up period was 12 months, and no deaths occurred in this series. Furthermore, we identified 85 studies in the literature review and extracted data regarding the diagnosis and management of these patients. The timely detection and effective management of this condition are essential for minimizing its associated morbidity and mortality.

摘要

尽管近期的诊断和治疗方法改善了颈椎硬膜外脓肿的预后,但发病率和死亡率仍然很高。我们研究的目的是明确颈椎硬膜外脓肿的临床表现,确定手术治疗的早期临床结果,并找出最有效的诊断和治疗方法。此外,我们分析了有关颈椎硬膜外脓肿的研究并进行了文献综述。本研究纳入了4例脊髓硬膜外脓肿患者。其中3例男性,1例女性,平均年龄53岁。3例患者出现运动功能障碍,1例患者通过脊柱影像学检查偶然确诊。所有患者均有发热,血培养均为阳性。金黄色葡萄球菌是脓肿培养中最常见的病原体。所有患者均接受了手术治疗,3例患者恢复了正常神经功能,但1例仍有轻度神经功能障碍,术后两年恢复。平均随访期为12个月,本系列中无死亡病例。此外,我们在文献综述中确定了85项研究,并提取了有关这些患者诊断和治疗的数据。及时发现并有效管理这种疾病对于将其相关的发病率和死亡率降至最低至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3daa/10342465/e7b932f8e8cd/jcm-12-04509-g001.jpg

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