針刺併發脊椎硬膜外膿瘍：二病例報告

Spinal Epidural Abscess as a Possible Complication of Acupuncture: Report of Two Cases

謝宜熹(Yi-Hsi Hsieh) ； 周崇頌(Chorng-Sonq Chou)

《中華民國復健醫學會雜誌》 30卷2期 (2002/06) Pp. 123-129

https://doi.org/10.6315/JRMA.200206.0123

摘要

脊椎硬膜外膿瘍為一少見之疾病，且以往無針刺併發脊椎硬膜外膿瘍之文獻報告。我們提出兩例於針刺後發生脊椎硬膜外膿瘍之病例報告。病例一為61歲男性，他在接受頸部推拿及針刺放血後，右上臂疼痛加劇及日漸無力，6 天後還演變為完全癱瘓及尿滯留。頸部核磁共振檢查發現為第三至第六頸椎脊椎硬膜外膿瘍。經手術及抗生素治療，他於9個月後，恢復至四肢輕癱、可獨自行走（但痙攣步態）。病例二為60歲女性，她在接受頸部針刺治療後，後上背部疼痛加劇並開始發燒，2天後排尿困難且兩下肢開始麻痛無力。頸胸部核磁共振檢查發現為第六頸椎至第三胸椎脊椎硬膜外膿瘍。經手術及抗生素治療後，恢復良好。雖然針刺後併發脊椎硬膜外膿瘍的情形很少見，但臨床上仍應對此嚴重之併發症高度警覺，以早期診斷及治療。

關鍵字

脊椎硬膜外膿瘍 ； 併發症 ； 針刺

並列摘要

Spinal epidural abscess is an uncommon disease, and is rarely reported as a complication of acupuncture. We present two cases of spinal epidural abscess which developed after acupuncture treatment. Case 1 was 61 years old male who suffered from progressive pain and weakness over right upper arm after cervical manipulation and acupuncture. He became qudriplegia with urine retention 6 days later. Cervical MRI showed C3-6 epidural abscess. After operation and antibiotics treatment, he recovered to qudriparesis and could walk with the spastic gait 9 months later. Case 2 was 60 years old female who suffered from fever and right upper back pain after acupuncture. Two days later, urine retention and progressive numbness and weakness over bilateral legs developed. MRI showed C6-T3 epidural abscess. After operation and antibiotics treatment, she recovered well. Although the spinal epidural abscess as a complication of acupuncture seems uncommon, our cases show one of a serious complication of acupuncture.

並列關鍵字

spinal epidural abscess ； complication ； acupuncture