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https://www.readbyqxmd.com/read/29916954/epidural-abscess-a-propensity-analysis-of-surgical-treatment-strategies
#1
Anisse N Chaker, Abhiraj D Bhimani, Darian R Esfahani, Clayton L Rosinski, Brett W Geever, Akash S Patel, Jonathan G Hobbs, Taylor G Burch, Saavan Patel, Ankit I Mehta
STUDY DESIGN: Observational analysis of retrospectively collected data. OBJECTIVE: A retrospective study was performed in order to compare the surgical profile of risk factors and perioperative complications for laminectomy and laminectomy with fusion procedures in the treatment of SEA. SUMMARY OF BACKGROUND DATA: Spinal epidural abscess (SEA) is a highly morbid condition typically presenting with back pain, fever, and neurologic deficits...
June 18, 2018: Spine
https://www.readbyqxmd.com/read/29916930/development-of-predictive-algorithms-for-pre-treatment-motor-deficit-and-90-day-mortality-in-spinal-epidural-abscess
#2
Akash A Shah, Paul T Ogink, Mitchel B Harris, Joseph H Schwab
BACKGROUND: Spinal epidural abscess is a high-risk condition that can lead to paralysis or death. It would be of clinical and prognostic utility to identify which subset of patients with spinal epidural abscess is likely to develop a motor deficit or die within 90 days of discharge. METHODS: We identified all patients ≥18 years of age who were admitted to our hospital system with a diagnosis of spinal epidural abscess during the period of 1993 to 2016. Explanatory variables were collected retrospectively...
June 20, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29893620/femoral-osteomyelitis-caused-by-cladophialophora-in-a-patient-without-known-immunocompromise
#3
Nirbhay S Jain, Christopher B Horn, Adrian A Coleoglou Centeno, Obeid N Ilahi, John E Mazuski, Grant V Bocchichio, Laurie J Punch
BACKGROUND: Chronic osteomyelitis associated with a stage IV decubitus ulcer is a challenging condition to manage, characterized by frequent relapses and need for long-term anti-microbial therapy. Although gram-positive cocci are the most common causes, fungal infections have been reported, usually in immunocompromised hosts. We present a case of Cladophialophora osteomyelitis in a patient without known immunocompromised that was managed with a Girdlestone pseudoarthroplasty. CASE REPORT: A 70-year-old male presented to our emergency room with fever, right hip pain, and purulent drainage from a right greater trochanter stage IV decubitus ulcer...
June 12, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29883820/extensive-spinal-adhesive-arachnoiditis-after-extradural-spinal-infection-spinal-dura-mater-is-no-barrier-to-inflammation
#4
Theresa Krätzig, Marc Dreimann, Klaus Christian Mende, Ingo Königs, Manfred Westphal, Sven Oliver Eicker
BACKGROUND: Spinal adhesive arachnoiditis (SAA) is an inflammatory process of the meninges. Cystic changes and cicatrisation may lead to neurological deficits and immobilization. Therapy is difficult and often unsatisfactory. We describe eight cases of extensive SAA following extradural spinal infection. METHODS: 238 patients with epidural abscess or osteomyelitis were treated at our institution between 2011 and 2018. We identified eight patients who developed extensive SAA on follow-up...
June 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29883818/successfully-conservative-management-of-delayed-cervical-spondylodiscitis-with-epidural-abscess-caused-by-esophageal-diverticulitis-a-case-report-and-review-of-literature
#5
Jinwei Ying, Shishen Pei, Linghao Su, Tianyong Wen, You Lv, Dike Ruan
BACKGROUND: Cervical spondylodiscitis with spinal epidural abscess (SEA) is not a rare medical condition that usually requires urgent decompression of neural structures and stabilization of the spine followed by antibiotic therapy for prevention from severe neurological deficits. CASE DESCRIPTION: In this report, we present a 43-year-old male patient with the chief complaint of neck pain and intermittent fever accompanying by slight dysphagia. After two weeks, he felt mild and transient numbness on the left upper limb...
June 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29866672/an-aggressive-form-of-haemophilus-parainfluenzae-infective-endocarditis-presenting-with-limb-weakness
#6
Naina McCann, Mohamad Fahed Barakat, Frank Schafer
We present the case of a 49-year-old man with a bicuspid aortic valve who presented to the emergency department with limb weakness and a fever. Blood tests revealed a fulminant septic process with Haemophilus parainfluenzae bacteraemia, anaemia and thrombocytopenia. Imaging revealed a cervical spinal abscess and discitis causing spinal cord compression, in addition to multiple cerebral septic emboli, pleural effusions and ascites. A transoesophageal echocardiogram (TOE) performed post decompression of his spinal collection showed native aortic valve endocarditis with an associated large aortic root abscess...
June 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29864561/application-of-cortical-bone-trajectory-screws-in-elderly-patients-with-lumbar-spinal-tuberculosis
#7
Shiyuan Shi, Xiaozhang Ying, Qi Zheng, Bo Zhu, Yanghui Jin, Jian Shen, Mingfeng Zheng, Shunping Hu
OBJECTIVE: To investigate the clinical efficacy of cortical bone trajectory screws (CBTs) in the treatment of elderly patients with lumbar spinal tuberculosis. METHODS: A total of 45 elderly patients with lumbar spinal tuberculosis were allocated to two groups based on different surgical methods: 22 patients in Group A received posterior CBT fixation combined with anterior debridement with a small incision and bone grafting, and 23 patients in Group B underwent posterior pedicle screw fixation combined with anterior debridement with a small incision and bone grafting...
June 1, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29798564/-treatment-of-multiple-segments-of-thoracolumbar-tuberculosis-using-posterior-unilateral-debridement-with-bone-graft-and-internal-fixation
#8
Zenghui Zhao, Yong Zhu, Wei Luo, Xing Du, Jianxiao Li, Yunsheng Ou, Zhengxue Quan
Objective: To explore the effectiveness and related issues in the treatment of multiple segments of thoracolumbar tuberculosis through posterior unilateral debridement with bone graft and internal fixation. Methods: The clinical data of 29 patients with multiple segments of thoracolumbar tuberculosis who met the selection criteria were retrospective analyzed between January 2012 and July 2015. There were 17 males and 12 females, with age of 21-62 years (mean, 37...
September 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/29796377/the-prognostic-accuracy-of-suggested-predictors-of-failure-of-medical-management-in-patients-with-nontuberculous-spinal-epidural-abscess
#9
Alexandra Stratton, Peter Faris, Kenneth Thomas
Study Design: Retrospective cohort study. Objectives: To test the external validity of the 2 published prediction criteria for failure of medical management in patients with spinal epidural abscess (SEA). Methods: Patients with SEA over a 10-year period at a tertiary care center were identified using ICD-10 (International Classification of Diseases, 10th Revision) diagnostic codes; electronic and paper charts were reviewed. The incidence of SEA and the proportion of patients with SEA that were treated medically were calculated...
May 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29791949/the-global-neurological-burden-of-tuberculosis
#10
Kiran Thakur, Mitashee Das, Kelly E Dooley, Amita Gupta
Central nervous system (CNS) involvement of tuberculosis (TB) is the most severe manifestation of TB and accounts for approximately 5 to 10% of all extrapulmonary TB (EPTB) cases and approximately 1% of all TB cases. TB meningitis (TBM) is the most common form of CNS TB, though other forms occur, often in conjunction with TBM, including intracranial tuberculomas, tuberculous brain abscesses, and spinal tubercular arachnoiditis. CNS TB often presents with nonspecific clinical features that mimic symptoms of other neurological conditions, often making diagnosis difficult...
April 2018: Seminars in Neurology
https://www.readbyqxmd.com/read/29774194/improper-use-of-thrombolytic-agents-in-acute-hemiparesis-following-misdiagnosis-of-acute-ischemic-stroke
#11
Min Chan Kim, Seok Won Kim
Objective: Acute hemiparesis is often an early presentation of acute ischemic stroke, though it can occur in various disorders. This study aimed to investigate the improper use of thrombolytic agents for patients with acute hemiparesis, following the misdiagnosis of acute ischemic stroke. Methods: We analyzed the clinical and radiological data of nine patients initially misdiagnosed with cerebral stroke in the emergency room from May 2013 to January 2017. All the patients were treated with tissue plasminogen activator (TPA) owing to the presence of acute hemiparesis...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29757891/spinal-epidural-abscess-in-an-infant-presenting-as-fever-and-respiratory-distress
#12
Katherine M Gupta, Khoon-Yen Tay
A 9-month-old healthy female presented during winter to the emergency department with a chief complaint of fever and prominent respiratory symptoms. She was discharged on oseltamivir with a presumptive diagnosis of influenza. She returned to the emergency department 2 days later with continued fever and more upper respiratory symptoms. She was admitted for intravenous hydration to the observation unit with a diagnosis of viral illness (with viral testing that returned positive for adenovirus) and dehydration...
May 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29757450/a-case-report-of-a-4-year-old-boy-with-intradural-spinal-cord-abscess-successfully-treated-with-adjuvant-hyperbaric-oxygen-therapy
#13
Ayse Sahin, Mustafa Kilic, Nazan Dalgic
Intradural spinal cord abscesses are rare infections in early childhood and usually result from pre-existing congenital anomalies of the spinal column. The formation of abscess may be the result of hematogenous spread. It is treated by surgical and parenteral antibiotic treatment, but some special cases may require additional treatments. This article presents a 4-year-old male patient who was operated because of spina bifida (meningocele and tethered cord) at the external center, and upon complains of not being able to walk after one month, he was operated with the diagnosis of spinal intradural abscess and referred to us to continue his treatment...
April 26, 2018: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29742719/cauda-equina-syndrome-following-an-uneventful-spinal-anesthesia-in-a-patient-undergoing-drainage-of-the-bartholin-abscess-a-case-report
#14
Waldo Merino-Urrutia, Milca Villagrán-Schmidt, Priscilla Ulloa-Vásquez, Rubén Carrasco-Moyano, Alberto Uribe, Nicoleta Stoicea, Sergio D Bergese
RATIONALE: Neuraxial anesthesia is a commonly used type of regional anesthesia. Cauda equina syndrome is an unusual and severe complication of neuraxial anesthesia, and is caused by damage to the sacral roots of the neural canal. We present a case of cauda equina syndrome following spinal anesthesia in a patient who underwent Bartholin abscess drainage. PATIENT CONCERNS: A 23-year old female scheduled to undergo surgical drainage of Bartholin abscess. Spinal anesthesia was performed with bupivacaine and fentanyl...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29735138/transpedicular-decompression-debridement-and-posterior-spinal-fusion-with-instrumentation-for-single-level-thoracic-spinal-tuberculosis-with-myelopathy-is-anterior-column-reconstruction-necessary
#15
Saumyajit Basu, Sri Krishna Chaitanya Kondety
OBJECTIVES: The purpose of this study is to study the safety and efficacy of single-stage transpedicular decompression/debridement and instrumented posterior spinal fusion for single-level thoracic spinal tuberculosis with myelopathy without anterior column reconstruction. SUMMARY OF BACKGROUND DATA: Existing literature has many reports of transpedicular decompression/debridement and instrumented posterior spinal fusion with anterior column reconstruction. The quoted loss of correction is around 2°, but there is no strong evidence analyzing the loss of kyphosis correction, assessment of fusion in the same, without anterior column reconstruction...
May 2018: Spine Deformity
https://www.readbyqxmd.com/read/29721349/abscess-due-to-textiloma-gossypiboma-retained-surgical-cottonoid
#16
Ali Akhaddar, Hassan Baallal, Abderrahim Elktaibi
Background: Surgical site infections following spinal surgery, including spinal abscesses, are rare but serious as they are major causes of morbidity, and even mortality. They are, however, rarely attributed to infected, retained surgical cottonoids or sponges (textiloma or gossypiboma) inadvertently left in an operative field. Case Description: A 53-year-old female with a history of two prior spinal operations at the L4-S1 levels (11 and 2 years previously) presented over a few weeks with the acute onset of a cauda equina syndrome (e...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29721126/simultaneous-occurrence-of-spinal-epidural-abscess-and-disk-herniation-causing-irreversible-neurologic-deficits-a-case-report-and-review-of-the-literature
#17
Abdullah Cetinkaya, Claude Pierre-Jerome
No abstract text is available yet for this article.
June 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29705812/imaging-assisted-diagnosis-and-characteristics-of-suspected-spinal-brucellosis-a-retrospective-study-of-72-cases
#18
Laiyong Tu, Xinmei Liu, Wenfei Gu, Zhenbin Wang, Enfeng Zhang, Aikenmu Kahar, Ge Chu, Jiang Zhao
BACKGROUND We clarified the imaging features of Brucella spondylitis to enhance our understanding of the disease and to minimize misdiagnosis. MATERIAL AND METHODS Imaging data (X-ray, computed tomography [CT], and magnetic resonance imaging [MRI] data) of 72 Brucella spondylitis patients treated from 2010 to 2017 were retrospectively analyzed; diagnoses was made by evaluating laboratory and pathological data. RESULTS X-ray films revealed changes in intervertebral space heights, the number of lateral osteophytes, and bone destruction, which were more severe in the following order: lumbosacral vertebrae (56 cases, 77...
April 29, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29682450/first-case-of-cervical-epidural-abscess-caused-by-brucellosis-in-saudi-arabia-a-case-report-and-literature-review
#19
Meshal Alyousef, Rabia Aldoghaither
Spinal epidural abscess (SEA) is an extremely rare and disastrous musculoskeletal complication of spondylodiscitis and sacroilitis secondary to brucellosis infection. Few case reports and retrospective studies have been published reporting patients with epidural abscesses mainly lumbar, and thoracic while cervical abscess are rare. Management of spinal epidural abscess due to Brucella species is not standard and remains controversial. To the best of our knowledge this is the first case of brucellar cervical epidural abscess reported in Saudi Arabia...
2018: IDCases
https://www.readbyqxmd.com/read/29682055/pneumorrhachis-following-chest-injury-a-rare-entity
#20
Shivender Sobti, S Bhaskar, Rajesh K Sharma, Ajay Choudhary
Pneumorrhachis (PR) - the phenomenon of intraspinal air - is a rare radiological finding. The presence of intraspinal air is usually after epidural injections, spinal manipulations, synovial cysts, degenerative disc disease, and epidural abscess. PR is mostly asymptomatic but can also be symptomatic. We report a case with PR after chest trauma and attempt to explain its development.
April 2018: Asian Journal of Neurosurgery
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