Management of an extensive spinal epidural abscess from C-1 to the sacrum

2010 ◽  
Vol 13 (6) ◽  
pp. 780-783 ◽  
Author(s):  
Muhammad Z. Tahir ◽  
Rameez Ul Hassan ◽  
S. Ather Enam
Keyword(s):  
Lower Limb ◽  
Rare Case ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Low Grade ◽  
Limb Weakness ◽  
Minimally Invasive Surgical ◽  
Lower Limb Weakness ◽  
Whole Spine ◽  
Spinal Epidural

The authors report a rare case of extensive spinal epidural abscess in an immunocompromised young woman. The patient presented with low-grade fever, back pain, and progressive lower limb weakness. The MR imaging of her whole spine revealed an epidural abscess extending from C-1 to the sacrum. She was treated using a minimally invasive surgical technique and showed excellent recovery. The authors review the current literature along with different modes of surgical treatment available for this unusual clinical entity.

scholarly journals Tuberculous lumbar spinal epidural abscess in a young adult (case report)

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 5
Author(s):  
Ghazwan Abdulla Hasan ◽  
Saif Mohammed Kani ◽  
Ahmed Alqatub
Keyword(s):  
Case Report ◽  
Lower Limb ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Mri Scan ◽  
Limb Weakness ◽  
Lower Limb Weakness ◽  
Lumbar Spinal ◽  
Spinal Epidural

Introduction: Spinal Epidural abscess (SEA) is an uncommon pathology that needs an urgent intervention to decompress the pressure on the spinal epidural sac, cord, and roots. The authors report a rare case of a young adult with lumbar spinal epidural tuberculous abscess occupying the spinal canal from L2–L5 vertebrae with extesion to the posterior paraspinal muscles and presenting with bilateral progressive lower limb weakness.   Case report: A 42 years old male teacher presented with a 15-day history of progressive difficulty to walking and bilateral lower limb weakness associated with fever, malaise and later on urinary incontinence. A magnetic resonance imaging (MRI) scan revealed a paraspinal intermuscular abscess and an abscess occupying the spinal canal compressing the dural sac from L2–L4/5, without any signs of vertebral involvement. Surgery was done by a posterior midline incision. Pus was evacuated from multiple pockets through the paraspinal muscle layers. Laminectomy for L3/4, and hemilaminectomy for L2/3, and L4/5 were performed. Pus and bone specimens were negative for acid-fast bacilli. However, both histopathological studies and Polymerase Chain Reaction (PCR) testing confirmed the presence of tuberculosis (TB). The patient received TB antibiotics, and a follow-up MRI scan at 2 months showed complete evacuation of the abscess. However, signs of L5 spondylitis were evident. No further surgery was needed as there was no vertebral collapse or neural compression and the patient's clinical condition was improving. He had normal right lower limb power and sensation and grade 4+ motor power of the left lower limb. Bowels and bladder function was normal. Conclusion: Isolated tuberculous spinal epidural abscess is a rare disease and should be treated urgently with evacuation and decompression. Signs of spondylitis or spondylodiscitis may appear later and therefore long follow up is recommended in tuberculous cases presenting with an isolated epidural abscess.

Aggregatibacter aphrophilus spinal epidural abscess

2020 ◽  
Vol 13 (7) ◽  
pp. e235320
Author(s):  
Antoine Altdorfer ◽  
Pierre Gavage ◽  
Filip Moerman
Keyword(s):  
Risk Factors ◽  
Lower Limb ◽  
Rare Case ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Surgical Drainage ◽  
Eikenella Corrodens ◽  
Aggregatibacter Aphrophilus ◽  
Progressive Neurological Deficit ◽  
Spinal Epidural

A 76-year-old woman with a rare case of spinal epidural abscess (SEA) that had no risk factors for such type of infection, presented symptoms of back pain, progressive neurological deficit of the lower limb and loss of sphincter control. A gadolinium-enhanced MRI confirmed the diagnosis of an SEA. The patient underwent laminectomy with surgical drainage, where cultures showed the presence of Aggregatibacter aphrophilus, a bacterium of the HACEK group (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species), rarely involved in SEA. Following surgery, the patient was treated with intravenous ceftriaxone for 6 weeks, and this gave excellent results.

scholarly journals Just the Facts: Risk stratifying non-traumatic back pain for spinal epidural abscess in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 753-755
Author(s):  
Zoe Polsky ◽  
Shawn K. Dowling ◽  
W. Bradley Jacobs
Keyword(s):  
Emergency Department ◽  
Back Pain ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Thoracic Spinal ◽  
Life Threatening ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Whole Spine ◽  
Spinal Epidural

A 65-year-old male with a history of hypertension presents to the emergency department (ED) with new onset of non-traumatic back pain. The patient is investigated for life-threatening diagnoses and screened for “red flag symptoms,” including fever, neurologic abnormalities, bowel/bladder symptoms, and a history of injectiondrug use (IVDU). The patient is treated symptomatically and discharged home but represents to the ED three additional times, each time with new and progressive symptoms. At the time of admission, he is unable to ambulate, has perineal anesthesia, and 500 cc of urinary retention. Whole spine magnetic resonance imaging (MRI) confirms a thoracic spinal epidural abscess. This case, and many like it, prompts the questions: when should emergency physicians consider the diagnosis of a spinal epidural abscess, and what is the appropriate evaluation of these patients in the ED? (Figure 1).

A Rare Case of Extensive Spinal Epidural Abscess in a Diabetic Patient

Spine ◽  
2010 ◽  
Vol 35 (2) ◽  
pp. E53-E56 ◽  
Author(s):  
Haitham Elsamaloty ◽  
Mohamed Elzawawi ◽  
Ahmad Abduljabar
Keyword(s):  
Diabetic Patient ◽  
Rare Case ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural

scholarly journals A rare case of holocord spinal epidural abscess

QJM ◽  
2019 ◽  
Vol 113 (4) ◽  
pp. 302-303 ◽  
Author(s):  
K K Sahu ◽  
I Chastain
Keyword(s):  
Rare Case ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural

scholarly journals Spinal cord disorder due to spinal epidural abscess secondary to thoracic facet joint septic arthritis—a rare case with a surprising evolution

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Teresa Plancha da Silva ◽  
Marta Amaral Silva ◽  
Sílvia Santos Boaventura ◽  
Mariana Castro Martins ◽  
Sérgio Teixeira Duro ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Septic Arthritis ◽  
Rare Case ◽  
Epidural Abscess ◽  
Facet Joint ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural

scholarly journals Response to: A rare case of holocord spinal epidural abscess

QJM ◽  
2019 ◽  
Vol 113 (4) ◽  
pp. 304-304
Author(s):  
C -C Lee ◽  
W -K Chang
Keyword(s):  
Rare Case ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural

scholarly journals Extensive spinal epidural abscess complicated with hydrocephalus

2015 ◽  
Vol 29 (4) ◽  
pp. 411-416
Author(s):  
Corneliu Balan ◽  
Ovidiu Carp ◽  
Corina Iordache
Keyword(s):  
Surgical Treatment ◽  
Epidural Abscess ◽  
Severe Infection ◽  
Favorable Outcome ◽  
Spinal Epidural Abscess ◽  
Csf Flow ◽  
Peritoneal Drainage ◽  
Appropriate Treatment ◽  
Whole Spine ◽  
Spinal Epidural

Abstract Spinal epidural abscess is a rare but severe infection requiring prompt recognition in order to have a favorable outcome and appropriate treatment, mainly surgical. We present one of the largest extensions of such abscess in literature, involving the whole spine. No surgical treatment was tempted due to the involvement of 19 levels but antibiotics. The evolution of the lesion was complicated with hydrocephalus, by mechanism of cervical block of CSF flow, and needed first external derivation and later ventriculo-peritoneal drainage.

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