Background: Panspinal infection usually presents with fever, back pain, neurological deficit, and in advanced cases multi-organ failure and septic shock. The choice of treatment for panspinal infection is challenging because these patients are usually medically unstable with severe neurological compromise. The objective of this study is to review management and long term outcomes for patients with panspinal infection.
Methods: A retrospective review of patients with panspinal infection treated in our center over a 5-year period [Jan 2010-Dec 2014] and a review of the current published literatures was undertaken.
Results: We identified 4 patients with panspinal infection. One case was managed medically due to high perioperative risk, whilst the other three were managed surgically whilst on antibiotic therapy. All 3 cases managed surgically improved neurologically and infection subsided, whereas the patient managed medically did not change neurologically and infection subsided.
Conclusions: Patients with panspinal infection should be treated surgically unless the medical risk of surgery or anaesthesia is prohibitive.
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http://dx.doi.org/10.21037/jss.2016.08.04 | DOI Listing |
Case Rep Infect Dis
May 2022
Ochsner Health System, New Orleans, Louisiana, USA.
Background: SEAs are infrequent; however, panspinal infections are even rarer, especially when GBS infection is involved. The cornerstone of treatment is based on early diagnosis and use of targeted antimicrobial therapy; in case of cord compression or neurological compromise, urgent surgical intervention should be pursued. Overall, it is an infrequent condition and therefore requires prospective multicenter studies.
View Article and Find Full Text PDFBMJ Case Rep
November 2019
Infectious Diseases, London North West University Healthcare NHS Trust, London, UK
Panspinal epidural abscesses are an extremely rare yet potentially fatal condition. Whether cases are best managed surgically or medically is currently controversial. A 63-year-old patient with diabetes presented initially with abdominal pain, back pain, urinary retention and constipation.
View Article and Find Full Text PDFWorld Neurosurg
February 2019
Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Background: Rapid progression of metastatic non-small cell lung cancer (NSCLC) after discontinuation of tyrosine kinase inhibitors or anaplastic lymphoma kinase (ALK) inhibitors has been described and is associated with a poor prognosis. We describe the first reported case of accelerated NSCLC tumor extension throughout the entire spinal epidural space.
Case Description: A 68-year-old woman with stage IV ALK-positive metastatic NSCLC presented with acute neck pain, urinary retention, and lower extremity weakness 15 days post discontinuation of alectinib.
World Neurosurg
February 2018
Seattle Science Foundation, Seattle, Washington, USA.
Background: Subdural empyema can present as a spinal subdural empyema (SSE) or a cranial subdural empyema (CSE). Although they differ somewhat in epidemiology, etiology, pathophysiology, and symptomatology and occur separately, they rarely manifest together. The aim of this article is to review the literature concerning the clinical presentation, clinical course, and treatment options for managing concurrently occurring SSE and CSE.
View Article and Find Full Text PDFJ Clin Neurosci
February 2018
Department of Neurological Surgery, Oregon Health & Science University, Portland, OR, United States. Electronic address:
Purpose: The authors present a holospinal epidural abscesses (HEA) case series and a single institution's experience with varied surgical approaches and outcomes.
Methods: Medical records were queried and reviewed (6 years) for patients with a spinal abscess diagnosis; HEA were selected. Medical history, comorbidities, blood and epidural pathogens, presentation symptoms, abscess location, presence of mass effect, surgical procedures, treatment regimens, and neurological outcomes were collected.
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