• The Korean Journal of Pain
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• v.9 no.1
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• pp.275-278
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• 1996

The placement of epidural catheter may cause complications such as epidural hematoma, epidural abscess and neural damage. Among the above complications, epidural abscess is a rare but serious complication. This report pertains to a diabetic metlitus patient who developed spinal epidural and subdural abscess after continuous epidural catheterization for management of pain caused by reflex sympathetic dystrophy. The patient experienced urinary incontinence, as a neurologic sign, 8 days after epidural catherization. In was considered that the poor prognosis was due to a combination effects of a delayed visit to the hospital for treatment, rapid progression of abscess and uncontrolled blood sugar level. We therefore recommend aseptic technique and proper control of blood sugar level to prevent infection during and after epidural catheterization for diabetic patients. Early diagnosis of epidural abscess following surgical procedure must be required to avoid sequelae.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.383-387
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• 2012

Spinal epidural abscess, if especially caused by Brucellosis is a very rare disease which is usually a consequence of spondylodiscitis. The spinal column can be affected at any joint; however, the lumbar spine is the most common region, especially at the level of the L4-5 and L5-S1. The frequency of spinal involvement usually seen at the lumbar, thoracic and cervical spine respectively. As an occupational disease in farmers, veterinaries, butchers, laboratory staff and shepherds, brucellosis can also occur by direct contact to animals and infected materials or ingestion of raw cheese, milk or unpasteurized milk products. In this study, we presented two cases with cervical spinal epidural abscess caused by brucella melitensis, which was successfully treated by surgical approach. Initial treatment was combined with antibiotic therapy after the surgery for 3 months.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.4
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• pp.195-201
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• 2014

The objective of this study is to report the improvement of one patient with physical sequelas induced by spinal epidural abscess surgery. The patient was treated by acupuncture therapy with pulsed electromagnetic therapy and herb medicine. We evaluated the effectiveness by numerical rating scale (NRS). As a result, the patient improved significantly NRS score. And the patient's symptoms were alleviated. We guess that the causes of the patient symptoms are chronic inflammation and fibrosis of dural. We conclude that acupuncture therapy with pulsed electromagnetic therapy is an effective treatment to reduce the residual pain after spinal epidural abscess surgery. But there is a limit on this study due to sufficient number of case. Further studies will be needed.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.430-433
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• 1996

It is common practice to use epidural catheter for anesthesia or for postoperative analgesia and other kinds of pain control. However, Intraspinal infection associated with this practice is rare event. We report a case of spinal subdural abscess occuring in patient who had recently received epidural catheterization. The cause in this case is not certain, although infection from the epidural catheter is the best possibility. We recommand an aseptic technique in all procedure for epidural or spinal analgesia.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.235-239
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• 2005

Although the incidence of epidural abscess is rare, once it occurs, its high morbidity rate and high mortality rate create a great deal of serious sequalae for these patient, if this condition is not diagnosed in time. We experienced a case of epidural abscess after performing percutaneous vertebroplasty in a patient who had a lumbar spinal compression fracture. This case will remind the pain clinician of the possibility of epidural abscess after such a procedure.

• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.395-399
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• 2001

Primary spinal epidural lymphoma(SEL), i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, is an unusual cause of spinal cord compression. The authors report a 48-year-old, diabetic woman presented with back pain followed by acute paraparesis and voiding difficulty. She had been treated with acupunctures on her back before admission, and complete blood count showed leukocytosis with neutrophilia and increased erythrocyte sedimentation rate(ESR). Thoracic spine magnetic resonance imaging(MRI) revealed an epidural mass extending from T5 to T8 with compression of the spinal cord. Emergency decompressive laminectomy was performed with a tentative diagnosis of spinal epidural abscess, but a B-cell lymphoma was final pathologic diagnosis. Further staging showed no other sites of lymphoma, and the spinal lesion was treated by chemotherapy and radiotherapy. The authors stress that primary SEL can mimic spinal epidural abscess(SEA) in the diabetic patient and should be a diagnostic consideration in patients with a syndrome of acute spinal cord compression manifested by a prodrome of back pain and neuroimaging consistent with an epidural compressive lesion, especially in a diabetic.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.439-442
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• 1996

Continuous epidural analgesia has been used widely for chronic pain control, especially in cancer patients. As one of the complications, paraplegia developed during continuous epidural analgesia may be caused by epidural abscess, epidural hematoma, neural damage, chronic adhesive arachnoiditis, anterior spinal artery syndrome, delayed migration of extradural catheter into subdural space or subarachnoid space and preexisting disease. A 55-years-old male with lung cancer was implanted with continuous thoracic epidural catheter for pain control. Twenty days after catheterization, moderate back pain, weakness of lower extremity and urinary difficulty were developed. We suspected epidural abscess at first and made differential diagnosis with MRI which showed metastatic cancer at T2-4 spine, And compressed spinal cord was the main cause of the lower extremity paralysis.

• Journal of Korean Neurosurgical Society
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• v.43 no.1
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• pp.37-40
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• 2008

Brucellosis, a zoonosis with worldwide distribution, is a systemic infection caused by facultative intracellular bacteria of the genus Brucella, which can involve multiple organs and tissues. We report an uncommon case of spondylodiscitis with epidural abscess due to Brucella in a male stockbreeder. Diagnosis was based on clinical history, and supported by Brucella serology and magnetic resonance imaging. Clinical and radiological improvement were observed with a combined antimicrobial therapy of doxycycline, rifampicin, and gentamycin.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1074-1079
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• 2000

We report a case of pyogenic spondylitis on L2 and L3 with diffuse epidural abscess up to T4 to L3 and large psoas abscess. A forty-nine-year old male was presented with progressive back pain, left flank pain and ab-dominal distention, weakness of the both legs and voiding and defecation difficulty during last 2 months. Initially multiple coronal hemilaminectomies from T4 to T12 were done for the treatment of diffuse thoracic epidural ab-scess. Then second operation via left retroperitoneal approach was performed for lumbar spondylitis and psoas abscess on third day after initial operation. After removal and curettage of pyogenic psoas and epidural abscess and spondylitis (L2-L3), iliac bone grafting with Keneda instrumentation from L1 to L4 was done simultaneously. Postoperative course has been unevenful without recurrent infection. The literature on diffuse epidural and large psoas abscess with pyogenic spondylitis are reviewed and instrumentation for stabilization of pyogenic spondylitis is also discussed.

• Journal of Yeungnam Medical Science
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• v.30 no.1
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• pp.36-38
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• 2013

While epidural abscesses are rare in hemodialysis patients, they can cause severe neurological complications that can be fatal because only nonspecific symptoms appear in the early stages of the infection. Their incidence increased recently due to intravenous drug abuse, invasive spinal surgery, percutaneous vertebral procedures, and the development of diagnostic modalities. The increased number of cases is related to the use of dialysis catheters in hemodialysis patients. If a patient has fever and back pain, doctors should eliminate the possibility of other common diseases and consider spinal epidural infection. Early diagnosis and proper treatment are important to prevent neurological complications. In this paper, the symptoms, blood work, magnetic resonanceimaging (MRI) findings, and clinical course of two hemodialysis patients who developed spinal epidural abscesses are described.