Long level (t4-l1) spinal epidural abscess in a diabetic patient - a case report -.
Spinal epidural abscesses are uncommon, but potentially devastating and often fatal. They can be found in normal patients, but they are more prevalent in immunocompromised patients, such as intravenous drug users, diabetics, chronic renal failure patients, pregnant women, and others. Timely diagnosis and treatment are the keys to optimizing outcome. Traditionally, treatment has comprised parenteral antibiotics and possible surgical intervention, such as decompression by pus drainage. We treated a long level (T4-L1) epidural abscess in a diabetic patient who had to undergo emergent long level decompression and drainage due to complete paralysis of the lower extremities and progression of neurologic deficit toward the upper thoracic level. Although lower extremity paralysis has not improved, the patient has completely recovered from lower extremity anesthesia. Further follow-up was not done because the patient expired due to sepsis eight month after surgery.
Hwang
Dae Woo
DW
Department of Orthopedic Surgery, National Medical Center, Seoul, Korea.
Lee
Churl Woo
CW
Nam
Hee Tae
HT
Kim
Byoung Min
BM
Choi
Hee Joon
HJ
J Spinal Disord. 2001 Dec;14(6):546-9
11723408
Br J Neurosurg. 2003 Apr;17(2):196-200
12820767
Neurosurg Focus. 2004 Dec 15;17(6):E12
15636569
Spine (Phila Pa 1976). 2004 Jul 15;29(14):E300-3
15247592
Surg Neurol. 1992 Apr;37(4):274-9
1595039
Neurosurgery. 2002 Aug;51(2):509-12; discussion 512
12182793