Ewald C, Gartemann J, Kuhn SA, Walter J, Kalff R
[Operative therapy for intraspinal empyema: a retrospective study of 23 patients] [English Abstract, Journal Article]
Z Orthop Unfall 2009 Jul-Aug; 147(4):487-92.
OBJECTIVE: Intraspinal empyema is a rare entity in spinal surgery. This study analyses the results after operating in 23 patients.
MATERIAL AND METHODS: This is a retrospective study of 23 patients suffering from intraspinal empyema treated operatively in our department. The data were obtained by analysing the patient documents including the radiological and microbiological data.
RESULTS: 18 patients suffered from different neurological deficits ranging from isolated mild hypaesthesia to paraplegia (n = 3). The operation was done as a one-level (n = 13), two-level (n = 8)or three-level (n = 2) microsurgical fenestration followed by irrigation and drainage of the pus. Staphylococcus aureus was the most frequent triggering organism. After a follow-up of 7 months 1 patient had died because of septic complications. Neurological deficits improved in 14 patients but 3 patients were still disabled in their daily life.
CONCLUSION: Epidural spinal empyema remains a challenge in spine surgery. Persistent neurological deficits and lethal complications make it a severe problem. Management comprises urgent surgical evacuation of the pus followed by targeted antibiotic therapy.
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