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脊髓硬膜外膿瘍의 臨床的 觀察

A Clinical Observation on Spinal Epidural Abscess

경북의대잡지 1971년 12권 1호 p.179 ~ 184
남위현,
소속 상세정보
남위현 (  ) - 경북대학교 의과대학 신경외과

Abstract


Twenty two cases of non-tuberculous spinal epidural abscess treated at the Department of Neurosurgery, Kyungpook National University Hospital during the past 7 years from 196? to 1969 were observed clinically.
The results were summerized 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 inside 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 thoracolumbar area which vas responsible for 50~;~ of total cases. Among others, thoracic (32~) and lumber (18%) areas were included. Bacterial culture was performed in 14 cases, and staphylococcus was isolated in 11 cases.
3. As sympotorns, 13 cases had back pain. Among others root pain, fever and headache were included. As neurological signs, paraplegia or parparesis in 19 cases, sphincter disturbance in 18 cases, sensory changes in 17 cases, back tenderness and stiff neck were included. As lumbar puncu~ e findings, in 3 cases aspirated pyogenic pus which confirmed diagnosis of spinal epidural abscess and manometric sutdies demonstrated a partial or complete block in 13 cases. The CSF analysis showed an increase of protein in 15 cases and in 12 cases did an increase in cell count.
4. The operative findings were classified in three types. The type I which was composed of pus only was 14%, the type 11 of pus and granulation tissue was 50%, and the type j[[ of granulation tissue and adhesion was 36;x. The post-operative prognosis was revealed excellent recovery in 5 cases, good recovery in 8 cases and unimprove-´nent of neurological findings in 6 cases. 3 cases succumbed to uncontrollable sepsis and pneumonia.

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