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成人颈椎急性化脓性椎间盘炎伴硬膜外脓肿——病例报告

Acute purulent discitis with epidural abscess of the cervical spine in an adult--case report.

作者信息

Fujiwara S, Morioka T, Ishibashi H, Takaki T, Fukui M

机构信息

Department of Neurosurgery, Faculty of Medicine, Kyushu University, Fukuoka.

出版信息

Neurol Med Chir (Tokyo). 1994 Jun;34(6):382-4. doi: 10.2176/nmc.34.382.

Abstract

A 52-year-old male presented with acute purulent discitis and epidural abscess of the cervical spine manifesting as neck pain and slight fever, followed by sudden onset of quadriparesis. Magnetic resonance (MR) imaging showed a low-signal-intensity area in the C6/7 disc space and epidural space ventral to the spinal cord with peripheral enhancement. Surgical exploration using an anterior approach revealed local discitis and epidural abscess, but no osteomyelitis of the neighboring vertebral bodies. Six months after the decompressive procedure to treat the purulent disc and epidural abscess, he had achieved almost full recovery. Such lesions are rare in adults, but should be considered especially when painful spinal symptoms are associated with fever. Early and definitive diagnosis can be achieved by MR imaging with enhancement.

摘要

一名52岁男性因颈椎急性化脓性椎间盘炎和硬膜外脓肿就诊,表现为颈部疼痛和低热,随后突然出现四肢瘫。磁共振成像显示C6/7椎间盘间隙及脊髓腹侧硬膜外间隙有低信号区,周边强化。采用前路手术探查发现局部椎间盘炎和硬膜外脓肿,但相邻椎体无骨髓炎。在对化脓性椎间盘和硬膜外脓肿进行减压手术后6个月,他几乎完全康复。此类病变在成人中罕见,但当脊柱疼痛症状伴有发热时应特别考虑。通过增强磁共振成像可实现早期明确诊断。

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