The pathogenesis of spinal epidural abscess: microangiographic studies in an experimental model

1988 ◽  
Vol 69 (1) ◽  
pp. 110-114 ◽  
Author(s):  
John A. Feldenzer ◽  
Paul E. McKeever ◽  
Dennis R. Schaberg ◽  
John A. Campbell ◽  
Julian T. Hoff
Keyword(s):  
Spinal Cord ◽  
Experimental Model ◽  
Spinal Cord Compression ◽  
Epidural Space ◽  
Epidural Abscess ◽  
Vascular Anatomy ◽  
Cord Compression ◽  
Spinal Epidural Abscess ◽  
Content Type ◽  
Spinal Epidural

✓ An experimental model of spinal epidural abscess was developed in rabbits by injecting Staphylococcus aureus into the posterior thoracolumbar epidural space. This model has been shown to reproduce the neurological, bacteriological, and radiological aspects of the human disease. In this study, the effect of the infectious epidural mass on the vasculature of the spinal cord in paraplegic rabbits was studied using microangiographic techniques. The normal vascular anatomy of the rabbit spinal cord was defined in control experiments. Vascular proliferation was demonstrated in the epidural space surrounding the abscesses. Anterior and paired posterior spinal arteries remained patent in paraplegic rabbits with mild or moderate spinal cord compression and in some cases of severe compression. In animals with severe compression, the anterior epidural venous plexus remained patent, but the dorsal spinal vein was occluded. Occlusion of perforating arteries occurred only with extreme spinal cord compression. These data indicate that the initial neurological deficit associated with experimental spinal epidural abscess is not due to vascular thrombosis.

Case: Spinal cord compression arising from a failure to diagnose and treat a spinal epidural abscess

Clinical Risk ◽  
2010 ◽  
Vol 16 (5) ◽  
pp. 192-194
Author(s):  
Ewan Lockhart ◽  
Robin Oppenheim ◽  
Jane Lang ◽  
Angus Moon ◽  
Jackie Linehan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Epidural Abscess ◽  
Cord Compression ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural

Edema and circulatory disturbance in the spinal cord compressed by epidural neoplasms in rabbits

1980 ◽  
Vol 52 (2) ◽  
pp. 203-209 ◽  
Author(s):  
Hiroya Ikeda ◽  
Yukitaka Ushio ◽  
Toru Hayakawa ◽  
Heitaro Mogami
Keyword(s):  
Spinal Cord ◽  
Experimental Model ◽  
Spinal Cord Compression ◽  
Early Stage ◽  
Vasogenic Edema ◽  
Cord Compression ◽  
Venous Stasis ◽  
Axonal Swelling ◽  
Content Type ◽  
Circulatory Disturbance

✓ An experimental model of spinal cord compression by epidural neoplasms was produced in rabbits by injecting a VX2 tumor-cell suspension anterior to the T-13 vertebral body. With this experimental model, edema and circulatory disturbance of the spinal cord compressed by epidural tumors were studied. The characteristic histopathological findings in the compressed spinal cord were edema and axonal swelling in the white matter. Water content and uptake of intravenously injected 99mTc pertechnetate in the compressed spinal cord were significantly greater than in the spinal cord distant from the tumor, and increased in proportion to the degree of neurological loss. Microangiography and fluorescein angiography demonstrated stenosis or obstruction of the epidural venous plexus and impairment of venous drainage in the compressed spinal cord at the early stage of neurological symptoms. It is suggested that venous stasis and subsequent vasogenic edema in the spinal cord play an important role in the symptomatology of metastatic epidural spinal cord compression.

Chondromyxoid fibroma: a rare cause of spinal cord compression

1974 ◽  
Vol 40 (1) ◽  
pp. 107-109 ◽  
Author(s):  
P. S. Ramani
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Epidural Space ◽  
Spinal Canal ◽  
Rare Case ◽  
Cord Compression ◽  
Chondromyxoid Fibroma ◽  
Content Type ◽  
Benign Nature ◽  
Fine Print

✓ A rare case is reported in which a primary chondromyxoid fibroma of the 12th rib spread into the epidural space of the spinal canal to cause spinal cord compression. The benign nature of the tumor is stressed and the only other reported case reviewed.

scholarly journals Myelopathy due to Spinal Extramedullary Hematopoiesis in a Patient with Polycythemia Vera

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Shuhei Ito ◽  
Nobuyuki Fujita ◽  
Naobumi Hosogane ◽  
Narihito Nagoshi ◽  
Mitsuru Yagi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Effective Treatment ◽  
Polycythemia Vera ◽  
Spinal Cord Compression ◽  
Epidural Space ◽  
Operative Therapy ◽  
Extramedullary Hematopoiesis ◽  
Cord Compression ◽  
Hematological Disorders ◽  
Spinal Epidural

Extramedullary hematopoiesis (EMH) occasionally occurs in patients exhibiting hematological disorders with decreased hematopoietic efficacy. EMH is rarely observed in the spinal epidural space and patients are usually asymptomatic. In particular, in the patients with polycythemia vera, spinal cord compression due to EMH is extremely rare. We report a case of polycythemia vera, in which operative therapy proved to be an effective treatment for myelopathy caused by spinal EMH.

scholarly journals Pressure Ulcer Associated with Testicular Prosthesis as a Rare Cause of Spinal Epidural Abscess

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Amulya Prakash ◽  
Rishi Raj ◽  
Aasems Jacob ◽  
Douglas Ross
Keyword(s):  
Spinal Cord ◽  
Pressure Ulcer ◽  
Epidural Abscess ◽  
Cord Compression ◽  
Sensory Function ◽  
Cervical Region ◽  
Spinal Epidural Abscess ◽  
Delay In Diagnosis ◽  
Spinal Cord Decompression ◽  
Spinal Epidural

Spinal epidural abscess is a neurologic emergency with a potential complication to the spinal cord such as paralysis. Frequently, it has a nonspecific initial presentation such as neck or back pain, and hence there is a delay in diagnosis. We present the case of a 60-year-old Caucasian male who presented to emergency room with one week of numbness and weakness of all four extremities. Neurological examination showed variable quadriparesis. Urgent MRI of spine with contrast revealed epidural abscess in the cervical region C4–C6 with resultant cord compression, the underlying etiology for hematogenous spread of infection being pressure ulcer associated with testicular prosthesis. Urgent neurosurgical intervention was done to achieve spinal cord decompression. Both blood and pus cultures were positive for Streptococcus intermedius, requiring prolonged administration of intravenous antibiotics. Clinical outcome was encouraging with progressive gain in motor and sensory function. Spinal epidural abscess is a rare diagnosis; hence, clinicians should have a high index of suspicion for timely diagnosis.

Pediatric spinal epidural metastases

1991 ◽  
Vol 74 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Steven L. Klein ◽  
Robert A. Sanford ◽  
Michael S. Muhlbauer
Keyword(s):  
Spinal Cord ◽  
Radiation Therapy ◽  
Soft Tissue ◽  
Spinal Cord Compression ◽  
Osteogenic Sarcoma ◽  
Cord Compression ◽  
Decompressive Laminectomy ◽  
Content Type ◽  
Spinal Epidural ◽  
Fine Print

✓ A total of 2259 children with solid malignant tumors were treated at St. Jude Children's Research Hospital between the years 1962 and 1987. Of these, 112 (5%) developed spinal epidural metastasis with spinal cord compression during the course of their disease process. Metastatic epidural spinal cord compression was caused most commonly by Ewing's sarcoma and neuroblastoma, followed by osteogenic sarcoma, rhabdomyosarcoma, Hodgkin's disease, soft-tissue sarcoma, germ-cell tumor, Wilm's tumor, and (rarely) hepatoma. There was no significant difference in outcome between patients with small-cell tumors (neuroblastoma, Hodgkin's disease, and germ-cell tumors) who received only chemotherapy and/or radiation therapy and the patients with similar lesions who received a decompressive laminectomy alone or prior to chemotherapy and/or radiation therapy. Patients with spinal cord compression from metastatic sarcoma (Ewing's sarcoma, soft-tissue sarcoma, osteogenic sarcoma, and rhabdomyosarcoma) showed a significant improvement with decompressive laminectomy alone or before medical therapy, compared to those who received radiation therapy and/or chemotherapy without posterior decompression. Pediatric tumors invade the spinal canal via the neural foramen, compressing the spinal cord in a circumferential manner, allowing decompressive laminectomy (posterior approach) to be an effective surgical approach. Sixty-six percent of children who had no evidence of motor or sensory function below the level of the compression became ambulatory after surgical decompression and medical treatment, regardless of tumor type.

Spinal cord compression by extramedullary hemopoietic tissue in sickle cell anemia

1975 ◽  
Vol 43 (4) ◽  
pp. 483-485 ◽  
Author(s):  
Abdel A. Ammoumi ◽  
Joanna H. Sher ◽  
Daniel Schmelka
Keyword(s):  
Spinal Cord ◽  
Sickle Cell ◽  
Spinal Cord Compression ◽  
Sickle Cell Anemia ◽  
Cord Compression ◽  
Content Type ◽  
Hemopoietic Tissue ◽  
Fine Print ◽  
Mass Recovery

✓ The authors report a patient with sickle cell anemia who suffered from paraplegia of 18 months duration due to spinal cord compression by a hemopoietic mass. Recovery following removal of the mass was complete.

scholarly journals Spontaneous Spinal Epidural Haematomas and the Prognostic Implications of Interval to Surgical Decompression: A Report of Two Cases

2009 ◽  
Vol 17 (2) ◽  
pp. 216-219 ◽  
Author(s):  
Colin Yi-Loong Woon ◽  
Benedict Chan-Wearn Peng ◽  
John Li-Tat Chen
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Lower Limb ◽  
Cord Compression ◽  
Surgical Decompression ◽  
Neurological Recovery ◽  
Uncontrolled Hypertension ◽  
Motor Deficit ◽  
Mri Features ◽  
Spinal Epidural

Spontaneous spinal epidural haematomas (SSEHs) are rare causes of spinal cord compression. We present 2 cases of thoracic SSEHs with similar magnetic resonance imaging (MRI) features. Patient 1 was on long-term oral anticoagulants and patient 2 had uncontrolled hypertension. Patient 1 presented with a dense motor deficit, whereas patient 2 developed progressive lower limb weakness. Decompression laminectomy and haematoma evacuation was performed 51 hours later for patient 1 and 14 hours later for patient 2. Both had recovered their lower limb power, but neurological recovery was greater for patient 2. In patients with bleeding diatheses or uncontrolled hypertension, acute SSEHs must be suspected when they present with atraumatic back pain and signs of spinal cord compression. The interval to surgical decompression greatly influences the prognosis for neurological recovery.

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