INTRAMEDULLARY SPINAL-CORD ABSCESS - A CASE-REPORT

Study Design. A case of an intramedullary spinal cord abscess is prese nted. The literature on this subject is carefully reviewed. Objectives . To give an overview of clinical presentation, radiographic examinati on, pathogenesis, treatment, and outcome of intramedullary spinal cord abscesses, Cases presented in the literature are arranged and the fin dings summarized. Summary of Background Data. Intramedullary spinal co rd abscesses are rare. Most frequently, single cases were reported, fo llowed by a short discussion. All previously reported cases were revie wed. Methods. After an extensive literature search, all cases of an in tramedullary spinal cord abscess (totaling 93 patients), including our s, were reviewed. Incidence, clinical presentation, neuroradiologic in vestigations, treatment, and pathogenesis are discussed. Results. Intr amedullary spinal cord absesses are rare. The presentation can be very confusing, mimicking thoracic or abdominal diseases. Magnetic resonan ce imaging is the best diagnostic technique, although the findings are not pathognomonic. Appropiate antibiotic therapy after surgical drain age is warranted. If left untreated, the outcome is bleak. Whereas mos t cultures remain sterile (38.7%), Staphylococcus or Streptococcus spe cies are involved frequently (23.7% and 17.2%), Conclusions. Although intramedullary spinal cord abscess is a rare disease, every spine surg eon should have knowledge of its existence because misjudgment and def erring adequate treatment may lead to an unfavorable outcome.