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Rehabilitation Practice and Science

Translated Title

以下背痛表現的脊椎硬膜外膿瘍：病例報告

Abstract

Spinal epidural abscess (SEA) is a rare infectious disorder often subject to a delayed diagnosis. In two United States hospitals, the incidence was between 0.2 and 1.2 per 10000 admissions. There are still no reports about the incidence of SEA in Taiwan. In this report, we present a 57-year-old diabetic woman who suffered from severe lower back pain for one week prior to admission. Neither physical infectious signs nor obvious neutrophilia was apparent.The responses to electrotherapy and nonsteroidal anti-inflammatory drugs were poor. The result of magnetic resonance imaging (MRI) study demondtrated an epidural soft tissue mass extemding from the L3-4 to S1 vertebral level. Decompressive hemiaminectomy from L3 to L5 with pus drainage from the epidural space was performed and followed by administration of antibiotics. The pathogen was proven to be Staphylococcus aureus. The symptoms were relieved after surgery and there was no residual neruological deficit. Lower back pain is a common clinical complaint. This infectious disorder, though rare, should be considered as a possibility if patients have an atypical clinical course and poor reponse to treatment. MRI can offer reliable information for diagnosis. More care should be taken with diabetic patients who have decreased immune function for fear of delayed diagnosis and management.

Language

English

First Page

161

Last Page

166

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