A Clinical Observation on Spinal Epidural Abscess.

Nam, Wee Hyun; Kim, Sang Chul; Kim, In Hong; Lee, Chul Woo

Original Article

Journal of Korean Neurosurgical Society 1972;1(1): 157-162.

Wee Hyun Nam, Sang Chul Kim, In Hong Kim, Chul Woo Lee

¹Kyungpuk University Hospital, Korea.
²Asea Neurosurgical Hospital, Korea.

ABSTRACT

Twenty-two cases of non-tuberculous spinale pidural abscess treated at the Dept. of Neurosurgery, Kyungpuk University Hospital during the past 7 years from 1962 to 1969 were observed clinically. The results were summarized as follows: 1. The ratio between male and female was 2; 1. The peak age incidence of these cases was between 40 and 50 years old with 36% of patients and between 10 and 20 years old with 27% of patients falling into this range. 2. The most important source of infection was the furuncle or abscesses of the skin, which was responsible for 50% of total known cases. The most frequent site of infection was thoracolumber area, which was responsible for 50% of total cases. Among others, thoracic (32%) and lumbar (18%) areas were included. Bacterial culture was performed in 14 cases and staphylococcus was isolated in 11 cases. 3. As for clinical symptoms 12 cases revealed back pain, there showed fever, root pain and headache in some cases. Paraplegia or paraparesis observed in 19 cases, sphincter disturbance in 18 cases, sensory deficits in 17 cases, back tenderness and stiff neck were included in these groups. Pyogenic pus was aspirated in 3 cases through lumbar puncture from the epidural space. Manometric studies during the lumber puncture revealed a partial or complete blockage in 13 cases. The CSF analysis showed an increase of protein in 15 cases and an increase of cell count in 12 cases. 4. The operative findings were classified in three types. The type I, which was composed of pus only, was 4%, The type Ii of pus and granulation tissue was 50% and the type II of granulation tissue and adhesion was 36%. The postoperative prognosis has revealed to be excellent in 5 cases, good recovery in 8 cases and unimprovement of neurological deficits in 6 cases. Three cases succumbed to uncontrollable sepsis and pneumonia.