Abramovitz J N, Batson R A, Yablon J S
Spine (Phila Pa 1976). 1986 Jun;11(5):418-20.
Twelve patients with neurologic complications of vertebral osteomyelitis are reported. Initial symptoms were due to diffuse intraspinal abscesses (epidural or subdural) in six patients and to kyphotic deformities in three. A localized anterior subligamentous abscess was found in one patient and a similar abscess with kyphosis in one. Kyphosis and diffuse epidural abscess were found in one patient. Operations were designed to relieve cord compression and maintain or improve spinal stability. Outcome was good in eight patients and poor in two; two patients died. Delayed neurologic deterioration after laminectomy occurred in two patients who presented with epidural abscess and minimal signs of osteomyelitis due to subsequent development of anterior abscess and spinal deformity. Therapy of this problem is discussed, with emphasis on choice of technique for neural decompression. Adequate decompression with attention to stability will yield a good result in the majority of cases.
本文报告了12例脊椎骨髓炎神经并发症患者。6例患者的初始症状是由弥漫性椎管内脓肿（硬膜外或硬膜下）引起，3例是由脊柱后凸畸形引起。1例患者发现局部前纵韧带下脓肿，1例患者有类似脓肿伴脊柱后凸。1例患者有脊柱后凸和弥漫性硬膜外脓肿。手术旨在缓解脊髓压迫并维持或改善脊柱稳定性。8例患者预后良好，2例预后不良；2例患者死亡。2例因硬膜外脓肿和骨髓炎体征轻微而接受椎板切除术的患者，术后出现神经功能延迟恶化，原因是随后出现了前侧脓肿和脊柱畸形。本文讨论了该问题的治疗方法，重点是神经减压技术的选择。在大多数情况下，充分减压并注意稳定性将取得良好效果。
