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Korean J Spine Search

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Cervico-thoraco-lumbar Spinal Epidural Abscess and Psoas Abscess Successfully Treated with Parenteral Antibiotic Therapy and Percutaneous Drainage: A Case Report.
Jae Il Lee, Geun Sung Song, Dong Wuk Son, June Woo Park
1Department of Neurosurgery, School of Medicine, Pusan National University, Busan, Korea. gnsong@pusan.ac.kr
2Department of Neurosurgery, Pusan Medical Center, Busan, Korea.
Abstract
We describe a 75-year-old man with a cervico-thoraco-lumbar spinal epidural abscess was extended to the psoas muscle. The patient complained high fever and back pain, followed by weakness of the lower extremities. He had received multiple epidural injections in a local pain clinic just few days before the onset of fever. The multi-segmental epidural abscess which was demonstrated by MRI compressed dural sac and cord. The best way to recommend him was to undergo a surgical decompression, but he refused the surgery. Next, we chose nonsurgical treatment such as longstanding parenteral antibiotic therapy and percutaneous drainage of psoas abscess. We could cultivate a causative organism and chose appropriate antibiotics. The patient experienced immediate relief of fever and the improvement of laboratory findings, gradual relief of back pain and full neurological recovery.
Keywords: Spinal epidural abscess;Psoas abscess;Conservative therapy


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