腰椎硬膜外膿瘍の1例

概要

論文の詳細を見る
Despite advances in neuroradiological imaging and neurosurgical management, spinal epidural abscess remains a serious problem with a high mortality rate. A 35-year-old man who suffered from pyrexia, lumbago, and gait disturbance experienced a rare complication of a lumbar epidural abscess. An epidural block injection of anesthesia for low back pain was performed 2 weeks before admission. Magnetic resonance imaging revealed an extradural mass, compressing the cauda equine at the level of L4-L5 and extending caudally into S1 and superficially into the subcutaneous region. The patient underwent a L4-L5 laminotomy with debridement of the abscess, irrigation, and drainage, followed by prophylactic therapy with antibiotics for 2 months. The symptoms associated with the lumbar epidural abscess disappeared soon after surgery. Immediate surgical drainage of the abscess, before the development of severe neurological deficits, combined with antibiotics, remains the treatment of choice. Close attention should be paid to this clinical entity because of the importance of early diagnosis and treatment and because there is a close relationship between early diagnosis and good outcomes.
日本脊髄外科学会の論文