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Spinal subdural empyema after a dural tear. Case report.
Adam S Wu1, Robert W Griebel, Kotoo Meguro
1Division of Neurosurgery, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Neurosurgical Focus
|January 8, 2005
Summary
Spinal subdural empyema is a rare complication. This case highlights how a dural tear after surgery can facilitate Staphylococcus aureus infection, leading to this serious condition.
Area of Science:
- Neurosurgery
- Infectious Diseases
Background:
- Spinal subdural empyema is a rare and severe condition.
- Prompt surgical drainage is the standard treatment.
Observation:
- A patient developed Staphylococcus aureus septicemia post-thoracic laminectomy.
- An incidental durotomy (dural tear) occurred during surgery.
- Postoperatively, the patient presented with back pain and lower extremity symptoms.
Findings:
- The patient was diagnosed with spinal subdural empyema caused by Staphylococcus aureus.
- This is the first reported case where a dural tear is implicated in the spread of infection to the subdural space.
- The patient experienced a favorable outcome despite delayed surgery due to pulmonary embolism.
Implications:
- Dural tears during spinal surgery may increase the risk of spinal subdural empyema.
- Early recognition and management are crucial for favorable outcomes in these rare cases.
- This case underscores the importance of meticulous surgical technique to prevent dural breaches.