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KMID : 0376119770040010045
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Medical Journal of the Red Cross Hospital
1977 Volume.4 No. 1 p.45 ~ p.49
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The Clinical Consideration for Spinal Epidural· Abscess
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金庸丘/Kim, Yong Goo
申光澈/李承洙/文明善/Shin, Kwang Chul/Lee, Sung Soo/Moon, Myoung Sun
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Abstract
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Infection involving the spinal cord and cauda equina are much less common than intracranial infection. Among the above,. bacterial infection in spinal epidural, space are relatively uncommon ´but well recognized entity in adult and children.- More than 300 cases with spinal epidural abscess are described in the literatures Because of its rarity, there is delay, in diagnosis and irreversible neurological sequel in. high percentage of cases.
Infection of the spinal epidural ´space are accompanied by fever, tachycardia, headache, pain and tenderness in the back, weakness of the lower extremities and finally a complete paraplegia.
The modes of infection are- 1) direct extension from inflammatory process in adjaccent tissues 2) perforating wounds or lumbar puncture 3) hematogenous route from the remote origin.
The most frequent causative organism is staphylococcus, but pneumococcus, streptococcus, pseudomonus, typhoid bacillus, odium coccidioides and fungus are causative organisms occasionally.
In spinal epidural abscess with complete paraplegia, the neurologic sequel are permanent and unhappy. So the spinal abscess is neururgical emergency in which, early diagnosis and prompt surgery are necessary to avert permanent cord damage
Recently, the spinal epidural abscess has increasing tendency. We have treated 5 cases with spinal epidural abscesses from Nov. 1974 to Apr. 1976.
The followings are results;
1) Sex incidence showed: male 2, female 3 and age incidence ranged from2l years to 38 years, but 4th decade was most common.
2) Most common mode of infection was unknown though all cases have been applied the acupuncture for the back pain several times.
3) Most available procedures of diagnosis were the, usual infectious symptoms, leukocytosis, increased, erythrocyte sedimentation rate, obstructive responce by Queckenstedt test and findings of myelography, including increased protein and pleocytosis in cerebrospinal fluid.
4) All 5 cases had been performed total lmainectomy from Ts-Ls, according to the lesions commonly in thoracic spine with spinal epidural abscess and had been treated with penicillin G. Methicillin and Geopen.
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