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Objective: The aim of this study is to elucidate the clinical characteristics of patients with spinal epidural abscess(SEA) and demonstrate the risk factors, treatments and neurologic outcomes.

Methods: We retrospectively reviewed the medical records and radiologic images of 35 patients admitted to our department with SEA between March 1987 and April 2011. While we performed decompressive laminectomy and abscess drainage on 19 patients (54.3%), and 16 patients (45.7%) initially received conservative therapy with antibiotics alone. Medical Research Council (MRC) scale was applied to estimate results objectively.

Results: The neurological outcome data showed improved MRC scale from 14 (40%) patients. 13 (37.1%) patients showed unchanged MRC scale and 8 (22.9%) patients revealed worsened MRC scale at the time of discharge. The patients with surgical treatment showed more improved MRC scale than the patients with conservative treatment and this was statistically significant (p=0.001) on univariate analysis. Initially, patients with decreased MRC scale and rapidly progressing neurological deficit underwent emergency surgery within 24 hours. Patients with intact MRC scale and minor neurological deficit received delayed surgery or conservative management with antibiotics. Among 19 patients those who experienced emergent operations within 24 hours showed better prognosis than those who underwent delayed operations after 24 hours.

Conclusion: Surgical treatment is the modality of choice in patients with SEA and urgent surgery especially is indicated in patients with neurological deficits. And early surgery is more effective in neurological improvements than delayed surgery and conservative management.

권호기사

권호기사 목록 테이블로 기사명, 저자명, 페이지, 원문, 기사목차 순으로 되어있습니다.
기사명 저자명 페이지 원문 목차
Clinical outcome and influencing factor for repeat lumbar discectomy for ipsilateral recurrent lumbar disc herniation Yeon Sung Jung, Hyu Jin Choi, Young-Min Kwon pp.1-5

Clinical outcomes of spinal epidural abscess HyunJin Ma, Insoo Kim pp.6-11

Comparison of operating time between stand-alone cage and a standard method for a single level cervical disc disease Chang Hyoun Kim, Chi Heon Kim, Chun Kee Chung, Tae-Ahn Jahng pp.12-17

Radiological analysis of symptomatic complications after bilateral laminotomy for lumbar spinal stenosis Jong Hun Seo, Gun Park, Chang Il Ju, Seok Won Kim, Seung Myung Lee pp.18-23

Ossified ligamentum flavum causing cervical myelopathy Jye Young Song, Jin Hoon Park, Sung Woo Roh pp.24-27

Late onset tuberculous spondylitis following kyphoplasty : a case report and review of the literature Hee Jin Kim, Dong Ah Shin, Kyung Gi Cho, Sang Sup Chung pp.28-31

Lymphomatoid granulomatosis with spinal involvement after childhood acute lymphoblastic leukemia Insoo Kim pp.32-36

Continuous multiple vertebral compression fractures in multiple myeloma patient Sang Moon Hong, Tae Wan Kim, Kwan Ho Park pp.37-40

Idiopathic lumbosacral spinal chronic subdural hematoma HyunJin Ma, Insoo Kim pp.41-43

Metronidazole induced encephalopathy with peripheral polyneuropathy in patient with spinal cord injury Gi Hoon Hwang, Young-Joo Sim, Ho Joong Jeong, Ghi Chan Kim, Bae Wook Sin, Ju Ho Jung pp.44-48

참고문헌 (22건) : 자료제공( 네이버학술정보 )

참고문헌 목록에 대한 테이블로 번호, 참고문헌, 국회도서관 소장유무로 구성되어 있습니다.
번호 참고문헌 국회도서관 소장유무
1 Multilevel Epidural Abscess Formation with Paraplegia in a Healthy 33-Year-Old Man Caused by Staphylococcus aureus (MSSA) 네이버 미소장
2 Ahl T, Hedstrom M, von Heijne A, Stiernstedt SH: Acute spinal epidural abscess without concurrent spondylodiscitis. Successful closed treatment in 10 cases. Acta Orthop Scand 70:199- 202, 1999 미소장
3 Akalan N, lan T: Infection as a cause of spinal cord compression: A review of 36 spinal epidural abscess cases. Acta Neurochir (Wien) 142:17-23, 2000 미소장
4 Curry WT Jr., Hoh BL, Amin-Hanjani S, Eskandar EN: Spinal epidural abscess: clinical presentation, management, and outcome. Surg Neurol 63:364-371, 2005 미소장
5 Hadjipavlou AG, Katonis PK, Gaitanis IN, Muffoletto AJ, Tzermiadianos MN, Crow W: Percutaneous transpedicular disectomyand drainage in pyogenic spondylodiscitis. Eur Spine J 13:707-713, 2004 미소장
6 Hematogenous pyogenic spinal infections and their surgical management. 네이버 미소장
7 Surgical strategies for vertebral osteomyelitis and epidural abscess. 네이버 미소장
8 Prognostic Factors of Pyogenic Spinal Infections 소장
9 Neurosurgery 네이버 미소장
10 Title comparison of primary and secondary spinal epidural abscesses: a retrospective analysis of 29 cases 네이버 미소장
11 Acute Panspinal Epidural Abscess 소장
12 Kim JS, Sung KH, Cho YW, Kim KH, Bae SD: Extensive Spinal Epidural Abscess: The Usefulness of Minimal Invasive Surgical Technique using Epidural Irrigation Catheter. Korean J Spine 8:221-224, 2011 미소장
13 Kowalski TJ, Layton KF, Berbari EF, Steckelberg JM, Huddleston PM, Wald JT, et al: Follow-Up MR imaging in Patients with Pyogenic Spine Infections: Lack of Correlation with Clinical Features. A JNR Am J Neuroradiol 28:693-699, 2007 미소장
14 Surgical Treatment of the Spontaneous Spinal Epidural Abscess 소장
15 Mann S, Schutze M, Sola S, Piek J: Nonspecific pyogenic spondylodiscitis: clinical manifestations, surgical treatment, and outcome in 24 patients. Neurosurg Focus 17:E3, 2004 미소장
16 Muzii VF, Mariottini A, Zalaffi A, Carangelo BR, Palma L: Cervical spine epidural abscess: experience with microsurgical treatment in Eight cases. J Neurosurg Spine 5:392-397, 2006 미소장
17 Two-stage Management for Vertebral Osteomyelitis and Epidural Abscess: Technical Note 네이버 미소장
18 Nussbaum ES, Rigamonti D, Standiford H, Numaguchi Y, Wolf AL, Robinson WL: Spinal epidural abscess: a report of 40 cases and review. Surg Neurol 38:225-231, 1992 미소장
19 Single-stage debridement and instrumentation for pyogenic spinal infections. 네이버 미소장
20 Epidural Spinal Infection 네이버 미소장
21 Pyogenic spondylitis and epidural abscess distant from the site of continuous epidural block in a patient with postherpetic neuralgia 네이버 미소장
22 Review of 10 Cases of Pyogenic Epidural Abscess of the Spine 소장

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