Quadriplegia caused by an epidural abscess occurring at the same level of cervical destructive spondyloarthropathy: a case report

BMC Musculoskeletal Disorders

Case Report

Jong-Tae Park¹  Ji-Hyun Ryu¹  Ki-Won Kim¹  Jun-Seok Lee¹ 

[1] Department of Orthopedic Surgery, Yeouido St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, 62 Yeouido-dong, 150-010, Youngdeungpo-ku, Seoul, Republic of Korea;

关键词: Cervical spine;    Destructive spondyloarthropathy;    Epidural abscess;    Spondylitis;    Hemodialysis;    Quadriplegia;    Case report;   

DOI  :  10.1186/s12891-016-1360-9

 received in 2016-08-16, accepted in 2016-12-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundDestructive spondyloarthropathy (DSA) is one of the major complications in patients undergoing long-term hemodialysis. To the best of our knowledge, an epidural abscess occurring at the level of preexisting cervical DSA has not been well described in the literature. We report a unique case of quadriplegia caused by an epidural abscess occurring at the same level of preexisting cervical DSA.Case presentationA 49-year-old woman was transferred to our emergency department with 5 days of sepsis, drowsy mental status, and quadriplegia below the C5 level. The patient had a medical history of hemodialysis for 10 years. Magnetic resonance imaging showed spinal cord compression by an epidural abscess at the level of preexisting cervical DSA. Blood culture revealed methicillin-sensitive Staphylococcus aureus. Infection of the arteriovenous (AV) shunt was considered as the primary focus of sepsis and pyogenic spondylitis. We performed an emergent open door laminoplasty and the vascular team debrided the infected AV shunt site. Approximately 8 months after surgery, the patient was able to perform activities of daily living somewhat independently.ConclusionsEmergent surgical decompression and intensive medical care led to successful recovery from a septic and quadriplegic state in this patient. When diagnosing a patient who has undergone long-term hemodialysis presenting with neurologic deficits, the possibility of infectious spondylitis at the same level as DSA should be considered.

【 授权许可】

CC BY   
© The Author(s). 2017