J Korean Orthop Assoc.  2017 Aug;52(4):354-358. 10.4055/jkoa.2017.52.4.354.

Infectious Spondylodiscitis Accompanied by Widespread Thoracolumbar Subdural Abscess

• Jeong YH
• Lee YS
• Park SJ

• KMID: 2387795
• DOI: http://doi.org/10.4055/jkoa.2017.52.4.354

Abstract

Subdural abscess is relatively rare compared with epidural abscess, but it can rapidly progress to complete paraplegia with a poorer outcome. In particular, the occurrence of widespread subdural abscess is extremely rare. We experienced a case of widespread thoracolumbar subdural abscess with infectious spondylodiscitis in the thoracic spine. We report this rare case with a review of relevant literatures.

Keyword

spine; empyema; subdural

MeSH Terms

Abscess*
Discitis*
Empyema
Epidural Abscess
Paraplegia
Spine

Figure

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  Figure 1 Preoperative sagittal (A) and T8 level axial (C) T1-weighted contrast enhanced cervicothoracic magnetic resonance imaging (MRI) shows T5–6 disc space narrowing, endplate destruction, and epidural swelling with enhancement, suggesting infective spondylodiscitis. It also shows widespread thoracolumbar posterior subdural fluid collection with a rim enhancement, which suggest subdural emphyema. Preoperative sagittal (B) and L2 level axial (D) T1-weighted contrast enhanced lumbar MRI shows widespread thoracolumbar posterior subdural fluid collection with rim enhancement, suggesting subdural emphysema. It also shows clumping of the cauda equina with an enhancement of dural sac, suggesting arachnoiditis.

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  Figure 2 Postoperative sagittal (A), T8 level axial (B) T1-weighted contrast enhanced cervicothoracic magnetic resonance imaging showing subsequently evacuated subdural abscess, and the patient had no evidence of residual or recurrent spinal infection.

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