Mattle H, Jaspert A, Forsting M, Sieb J P, Hänny P, Ebeling U
Dtsch Med Wochenschr. 1986 Oct 24;111(43):1642-6. doi: 10.1055/s-2008-1068685.
An acute spinal epidural abscess is a rare cause of paraplegia, seen in seven patients over a period of ten years. All patients had fever and severe localized back-pain. Unless treated, within hours or a few days, there will be root defects and rapidly progressive paraplegia. Staphylococcus is the most frequent causative organism and clinically manifest septicaemia is common. Rapid diagnosis and treatment are essential in deciding the patient's fate. Myelography is an important additional examination as it demonstrates the abscess in 96% of cases. Non-contrast radiology is of little value. High-dosage antibiotics and surgical spinal decompression are the cardinal treatment procedures. Antibiotics alone are justified only so long as there are no neurological deficits and neurosurgical intervention, if needed, is immediately available.
急性脊髓硬膜外脓肿是截瘫的罕见病因,在十年期间有七例患者。所有患者均有发热和严重的局部背痛。除非进行治疗,否则在数小时或数天内,将会出现神经根损害和迅速进展的截瘫。葡萄球菌是最常见的致病微生物,临床上常见败血症表现。快速诊断和治疗对于决定患者的预后至关重要。脊髓造影是一项重要的辅助检查,因为它在96%的病例中能显示脓肿。无对比剂的放射学检查价值不大。大剂量抗生素和手术脊髓减压是主要的治疗方法。只有在没有神经功能缺损且如有需要可立即进行神经外科干预的情况下,单独使用抗生素才是合理的。