Successful treatment of extended epidural abscess and long segment osteomyelitis: a case report and review of the literature.
Surg Neurol
; 69(2): 117-20; discussion 120, 2008 Feb.
Article
em En
| MEDLINE
| ID: mdl-17825364
ABSTRACT
BACKGROUND:
Spinal osteomyelitis and epidural abscess are complicated medical conditions. Diagnosis is often delayed because of cormorbidity. The time of instrumentation is still controversial. However, there is no doubting the indication of spinal hardware implantation when spinal fusion is needed. Long segment osteomyelitis and extended epidural abscess are rare. The treatment is challenging for neurosurgeons. We report a case of extended epidural abscesses and long segments of osteomyelitis.METHODS:
One-stage meticulous debridement, anterior cervical corpectomies, and spinal fusion with mesh cage and titanium plate were performed on the patient. Hyperbaric oxygenation and 6 weeks of intravenous antibiotics were prescribed as adjuvant therapy.RESULTS:
Both clinical presentations and imaging studies showed a good response to the treatment. The patient returned to his life 3 months later.CONCLUSIONS:
This case illustrates that spinal instrumentation is not an absolute contraindication in the presence of epidural abscesses and vertebral osteomyelitis. Combined surgical debridement at a critical level, with adjuvant antibiotics and hyperbaric oxygenation, is a safe and effective therapy in those with neurologic deficits, spinal instability, and extended epidural abscess.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Osteomielite
/
Fusão Vertebral
/
Infecções Estafilocócicas
/
Vértebras Cervicais
/
Abscesso Epidural
Tipo de estudo:
Diagnostic_studies
Limite:
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article