Asian Spine J.  2008 Jun;2(1):55-58. 10.4184/asj.2008.2.1.55.

Long Level (T4-L1) Spinal Epidural Abscess in a Diabetic Patient: A Case Report

• Hwang DW
• Lee CW
• Nam HT
• Kim BM
• Choi HJ

• KMID: 1721136
• DOI: http://doi.org/10.4184/asj.2008.2.1.55

Abstract

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.

Keyword

Spinal epidural abscess; Diabetics; Multilevel laminectomy

MeSH Terms

Anesthesia
Anti-Bacterial Agents
Decompression
Drainage
Drug Users
Epidural Abscess
Female
Follow-Up Studies
Humans
Immunocompromised Host
Kidney Failure, Chronic
Lower Extremity
Neurologic Manifestations
Paralysis
Pregnant Women
Sepsis
Suppuration
Anti-Bacterial Agents