Bartels R H, Gonera E G, van der Spek J A, Thijssen H O, Mullaart R A, Gabreëls F J
Department of Neurosurgery, University Hospital Nijmegen, The Netherlands.
Spine (Phila Pa 1976). 1995 May 15;20(10):1199-204. doi: 10.1097/00007632-199505150-00017.
A case of an intramedullary spinal cord abscess is presented. The literature on this subject is carefully reviewed.
To give an overview of clinical presentation, radiographic examination, pathogenesis, treatment, and outcome of intramedullary spinal cord abscesses. Cases presented in the literature are arranged and the findings summarized.
Intramedullary spinal cord abscesses are rare. Most frequently, single cases were reported, followed by a short discussion. All previously reported cases were reviewed.
After an extensive literature search, all cases of an intramedullary spinal cord abscess (totaling 93 patients), including ours, were reviewed. Incidence, clinical presentation, neuroradiologic investigations, treatment, and pathogenesis are discussed.
Intramedullary spinal cord abscesses are rare. The presentation can be very confusing, mimicking thoracic or abdominal diseases. Magnetic resonance imaging is the best diagnostic technique, although the findings are not pathognomonic. Appropriate antibiotic therapy after surgical drainage is warranted. If left untreated, the outcome is bleak. Whereas most cultures remain sterile (38.7%), Staphylococcus or Streptococcus species are involved frequently (23.7% and 17.2%).
Although intramedullary spinal cord abscess is a rare disease, every spine surgeon should have knowledge of its existence because misjudgment and deferring adequate treatment may lead to an unfavorable outcome.
本文报告一例脊髓髓内脓肿病例，并对该主题的文献进行了仔细回顾。
概述脊髓髓内脓肿的临床表现、影像学检查、发病机制、治疗及预后。对文献中报道的病例进行整理并总结研究结果。
脊髓髓内脓肿较为罕见。多数情况下仅报道单个病例，随后进行简短讨论。对所有既往报道的病例进行了回顾。
在广泛检索文献后，对包括我们病例在内的所有脊髓髓内脓肿病例（共93例患者）进行了回顾。讨论了发病率、临床表现、神经影像学检查、治疗及发病机制。
脊髓髓内脓肿较为罕见。其表现可能极具迷惑性，类似胸腹部疾病。磁共振成像虽是最佳诊断技术，但其表现并无特异性。手术引流后应给予适当的抗生素治疗。若不治疗，预后不佳。多数培养结果为无菌（38.7%），但葡萄球菌或链球菌属感染较为常见（分别为23.7%和17.2%）。
尽管脊髓髓内脓肿是一种罕见疾病，但每位脊柱外科医生都应了解其存在，因为判断失误和延误适当治疗可能导致不良后果。
