Volume 72, Issue 4 , Pages 210-213, April 2009
Post-traumatic Osteomyelitis with Spinal Epidural Abscess of Cervical Spine in a Young Man with No Predisposing Factor
Article Outline
Spinal osteomyelitis with epidural abscess is a rare disease. Most patients have 1 or more predisposing factors, such as impaired immune system secondary to diabetes mellitus, chemotherapy for cancer, immunological compromised disease, and chronic renal or hepatic impairment. We present a case of a physically steady young man without any predisposing risk factor who suffered from cervical osteomyelitis with epidural abscess after neck blunt injury. This patient recovered well after one-stage anterior surgical debridement with implant instrumentation and proper antibiotics treatment. The initial accurate diagnosis rate of spinal epidural abscess is low, even in patients with predisposing factor(s). We present this case to raise the attention of medical staff to this disease in patients with or without any predisposing factor(s) in order to establish early diagnosis and treatment. Our case report also indicates that with adequate debridement and antibiotic coverage, one-stage surgery is a safe and efficacious method to treat patients with cervical spinal epidural abscess.
Key Words: cervical spine , epidural abscess , osteomyelitis
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References
- . Osteomyelitis of the cervical spine: a potentially dramatic disease . J Spinal Disord Techniques . 2002;15:110–117
- . Neurosurgical care of spinal epidural, subdural, and intramedullary abscesses and arachnoiditis . Orthop Clin North Am . 1996;27:125–136
- . Spinal epidural abscess . N Engl J Med . 2006;355:2012–2020
- . Spinal infection: evaluation with MR imaging and intraoperative US . Radiology . 1988;169:765–771
- . Hematogenous pyogenic spinal infections and their surgical management . Spine . 2000;13:1668–1679
- . Spinal epidural abscesses: a retrospective analysis of clinical manifestations, sources of infection, and outcomes . Chang Gung Med J . 2004;27:351–358
- . Disseminated actinomycosis with spinal cord compression: report of two cases . Neurology . 1979;29:890–893
- . Spinal epidural abscess . N Engl J Med . 1975;293:463–468
- . Spinal epidural abscess: a meta-analysis of 915 patients . Neurosurg Rev . 2000;232:175–204
- . Bacterial spinal epidural abscess: review of 43 cases and literature survey . Medicine . 1992;71:369–385
- . Epidural spinal infection. Variability of clinical and magnetic resonance imaging findings . Spine . 1997;22:544–551
- . Spinal epidural abscess: evaluation of factors influencing outcome . Neurosurgery . 1996;39:958–964
- . Surgical treatment of the spontaneous spinal epidural abscess . Surg Neurol . 1992;37:274–279
- . Primary reconstruction for spinal infection . J Neurosurg . 1997;86:981–989
- . Contemporary management of spinal osteomyelitis . Neurosurgery . 1999;44:1018–1026
- . Spinal epidural abscess-experience with 46 patients and evaluation of prognostic factors . J Infect . 2002;45:76–81
PII: S1726-4901(09)70057-7
doi:10.1016/S1726-4901(09)70057-7
© 2009 Elsevier. Published by Elsevier Inc. All rights reserved.
Volume 72, Issue 4 , Pages 210-213, April 2009
