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[Cervical spinal epidural abscess: case report].

T Kuwata1, T Nishiguchi, Y Kinoshita

  • 1Department of Neurological Surgery, Wakayama Medical College, Kihoku Hospital.

No Shinkei Geka. Neurological Surgery
|March 1, 1990
PubMed
Summary

Cervical spinal epidural abscess is a rare condition with a poor prognosis, often leading to respiratory issues. This case highlights the challenges in diagnosing and treating this rare condition, even with prompt intervention.

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Area of Science:

  • Neurology
  • Infectious Diseases

Background:

  • Spinal epidural abscesses are typically found in the thoracic or lumbar spine.
  • Cervical spinal epidural abscesses are rare and associated with poor outcomes due to potential respiratory compromise.

Observation:

  • A 77-year-old male presented with tetraparesis and dyspnea, following a femoro-femoral bypass and subsequent wound infection.
  • Symptoms included rapid onset of neck pain, hand numbness, motor weakness, sensory loss below C4, and bladder dysfunction.
  • Neurological examination revealed flaccid tetraplegia and paralysis of intercostal muscles.

Findings:

  • Spinal CT identified an anterior epidural mass from C2 to C6, causing posterior spinal cord displacement.
  • Myelography demonstrated a complete blockage at the C7-T1 level.

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  • Staphylococcus aureus was identified as the causative agent.

    • Implications:

    • Despite emergency laminectomy, abscess evacuation, and antibiotic treatment, the patient experienced minimal neurological recovery and succumbed to the infection.
    • This case underscores the critical nature and poor prognosis of cervical spinal epidural abscesses, emphasizing the need for heightened awareness and rapid intervention.