Epidurit acute spinal

Epidurit acute spinal (epidural abscess) - focal purulent inflammation of epidural spinal cord tissue.

Etiology, pathogenesis. The disease occurs as a complication of purulent foci of infection (Staphylococcus aureus), wherever located, septicopyemia or osteomyelitis of the spine. Epidural abscess formation causes compression of the spinal cord.

Symptoms within. Against obscheinfektsionnyh manifestations (high fever, neutrophilia, increased erythrocyte sedimentation rate, total serious condition) occur intense radicular pain. Against this background quickly formed spinal cord compression in the form of para- or quadriplegia, loss of sensation below the level of the abscess and pelvic disorders. Lumbar puncture reveals a certain degree of blockade of subarachnoid space (Kvekkenshtedta test) and increasing the protein content of the cerebrospinal fluid. Lumbar puncture, however, only permissible if the cervical or thoracic hearth. Trying to study tse-rebrospinalnoy liquid at lumbosacral localization abscess inevitably fraught with infection in the subarachnoid space, which entails the development of purulent meningitis.

Diagnosis epidurita is relatively simple and is based on a combination of obscheinfektsionnyh with radicular symptoms, spinal. The greatest difficulty is differentiation epidurita from transverse myelitis. Due to the fact that the isolated myelitis is a rare disease in all cases of doubt, priority should be given epidurita, dictates the need for emergency surgery. Showing myelography and computed tomography.

Treatment with surgery alone: ​​laminectomy and removal of an abscess. Before and after surgery should be prescribed massive doses of antibiotics.

Forecast. With timely surgical intervention is usually recovery occurs. In severe cases, irreversible spinal cord damage, paralysis, bed sores, urinogenous infection.