Leys D, Lesoin F, Destee A, Jomin M, Christiaens J L, Warot P
Presse Med. 1984 Mar 10;13(10):597-9.
Twenty-three cases of acute spinal epidural infection due to common pathogens were retrospectively studied. Pain is not always present initially and usually appears 15 to 32 days after the primary infection, which is only found in one-half of the cases. When established, the condition is characterized by spinal rigidity, signs of infection, and compression of the cord or cauda equina. The diagnosis is confirmed by surgery, radiology (myelographic blockade, spondylodiscitis) or the finding of pus in the epidural space at lumbar puncture. A frequently delayed diagnosis explains the poor prognosis of these infections. Treatment should always include an antibiotic active against staphylococci, which are by far the most common pathogens. The indications for surgery are discussed in the light of published data compared to the authors' own experience.
对23例由常见病原体引起的急性脊髓硬膜外感染进行了回顾性研究。疼痛最初并不总是存在,通常在原发感染后15至32天出现,而这仅在一半的病例中出现。确诊后,该病的特征为脊柱僵硬、感染迹象以及脊髓或马尾受压。通过手术、放射学检查(脊髓造影阻滞、脊椎间盘炎)或腰椎穿刺时在硬膜外间隙发现脓液来确诊。诊断经常延迟导致这些感染的预后较差。治疗始终应包括使用对葡萄球菌有效的抗生素,因为葡萄球菌是迄今为止最常见的病原体。根据已发表的数据并结合作者自身经验对手术指征进行了讨论。