Spinal Epidural Abscess after Epidural Anesthesia: A Case Report and Literature Review

硬脊膜外麻醉後併發脊髓硬脊膜外膿瘍病例報告與文獻回顧

董奕維(Yi-Wei Tung) ； 方前量(Chien-Liang Fang) ； 蔡忠斌(Chong-Bin Tsai) ； 陳明山(Ming-Shan Chen)

《童綜合醫學雜誌》 14卷2期 (2020/12) Pp. 84-87

https://doi.org/10.3966/207135922020121402005

摘要

We report a case of a patient with spinal epidural abscess (SEA) after an epidural catheter placement for analgesia during a cesarean section. The parturient was healthy and did not present any risk factors for SEA. Four days postoperatively, worsened back pain and erythema with pus discharge over the epidural insertion site accompanied by sensory deficits in the lower extremities were noted. Magnetic resonance imaging revealed SEA with adjacent inflammation of the paravertebral soft tissue. Emergency laminectomy and SEA removal were performed, followed by a 6-week antibiotic therapy course with vancomycin. The parturient completely recovered from her neurologic deficiencies. In addition, several research articles on SEA were reviewed and discussed in this study.

關鍵字

spinal epidural abscess ； epidural anesthesia

並列摘要

我們在此報告一個病例。患者施行剖腹產，採用硬膜外導管置入麻醉，術後發生脊髓硬膜外膿腫。患者是一位健康的年輕女性，沒有任何風險因素。術後4天，患者背部疼痛，伴隨注意到硬膜外針入的部位，有紅腫和膿液排出現象，同時合併下肢感覺缺損。緊急對患者安排核磁共振成像，報告顯示脊髓硬膜外膿腫伴有椎旁軟組織的相鄰炎症。於是進行了緊急椎板切除術和切除脊髓硬膜外膿腫。隨後輔以萬古黴素，進行為期六週的抗生素治療。然後患者完全恢復並沒有遺留任何的神經缺損。此外，我們還回顧了幾篇關於脊髓硬膜外膿腫的研究文章，並在此進行討論。

並列關鍵字

脊髓硬膜外膿腫 ； 硬脊膜麻醉