Giuffrida S, Chiaramonte I, Saponara R, Greco S, Giammona G, Nicoletti G, Le Pira F
Institute of Neurosurgical Sciences, University of Catania, Italy.
J Neurosurg Sci. 1997 Jun;41(2):219-23.
Cervical epidural abscess (CEA) at first often goes unrecognized and it is to be suspected in patients suffering by spinal ache, root pain, neurological deficit and fever. Staphylococcus aureus is the most frequent etiologic agent. At present MRI is the study of choice for the diagnosis of CEA. We suggest a serial MRI study in close time in at first doubtful cases of CEA. When the responsible organism is not identified and there are also compressive signs of the spinal cord, the treatment of choice is surgical decompression followed by selective antibiotic therapy. The duration of antibiotic therapy may be established not only by clinical judgement, but also by serial MRI study, which gives direct information about disease evolution.
颈椎硬膜外脓肿(CEA)起初常常未被识别,对于有脊柱疼痛、神经根痛、神经功能缺损和发热的患者应怀疑此病。金黄色葡萄球菌是最常见的病原体。目前,MRI是诊断CEA的首选检查方法。对于起初存疑的CEA病例,我们建议短期内进行系列MRI检查。当致病微生物未明确且存在脊髓受压体征时,首选治疗方法是手术减压,随后进行选择性抗生素治疗。抗生素治疗的疗程不仅可以通过临床判断确定,还可以通过系列MRI检查确定,后者可提供有关疾病进展的直接信息。