Chang C Z, Huang T Y, Howng S L
Department of Surgery, Kaohsiung Medical College Hospital, Taiwan, Republic of China.
Kaohsiung J Med Sci. 1997 Jul;13(7):457-61.
Despite modern medical advances, the morbidity and mortality rates associated with spinal epidural abscess remain significant, and the diagnosis is elusive. The incidence of spinal epidural abscess is approximately one to two cases per 10,000 among all patients admitted to hospitals. The symptoms of spinal epidural abscess are varied but include lower back pain, fever, local tenderness and neurological deficit especially in such high risk groups as patients with diabetes, intravenous drug abuse, chronic renal failure, alcoholism, liver disease and immunocompromization. Accumulation of data is difficult in that many physicians will never see a case during their careers. Herein, we present a case with lower back pain associated with both lower legs weakness. His abdomenon CT revealed retroperitonium and right perirenal abscess. External drainage as well as antibiotic treatment was done immediately. However, the lower legs weakness became severe and a lumbar spine MRI revealed T11-L4 epidural abscesses and L2-3 intervertebral space pus formation. Then, the patient was transfered to our Neurosurgical Ward for further treatment. His postoperative condition improved in both lower legs. This case report is to enhance the recognition and treatment of spinal epidural abscess, a rare affliction.
尽管现代医学取得了进步,但与脊柱硬膜外脓肿相关的发病率和死亡率仍然很高,且诊断困难。在所有住院患者中,脊柱硬膜外脓肿的发病率约为万分之一至二。脊柱硬膜外脓肿的症状多种多样,但包括下背部疼痛、发热、局部压痛和神经功能缺损,尤其是在糖尿病、静脉药物滥用、慢性肾功能衰竭、酗酒、肝病和免疫功能低下等高危人群中。由于许多医生在其职业生涯中可能从未见过这种病例,因此积累数据很困难。在此,我们报告一例伴有双下肢无力的下背部疼痛病例。他的腹部CT显示腹膜后和右肾周脓肿。立即进行了外部引流和抗生素治疗。然而,双下肢无力变得严重,腰椎MRI显示T11-L4硬膜外脓肿和L2-3椎间隙积脓。随后,患者被转入我们的神经外科病房进行进一步治疗。他术后双下肢状况有所改善。本病例报告旨在提高对脊柱硬膜外脓肿这种罕见疾病的认识和治疗水平。