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Spinal Epidural Abscess in Patients with Chronic Renal Failure: A Single-Center Experience

Yıl 2019, Cilt: 5 Sayı: 3, 209 - 214, 01.07.2019
https://doi.org/10.5455/umj.20190719032811

Öz

Background: Spinal epidural abscess SEA is an uncommon condition that can evolve to severe neurologic deficit or death if the diagnosis is delayed. We noticed an increase in the number of cases of SEA, with the majority in patients with chronic renal failure. The purpose of the study was to investigate the relationship between chronic renal failure CRF and spinal epidural abscess SEA . Materials and Methods: This retrospective study was conducted with the medical records of CRF patients who were treated for SEA in a single tertiary center. Clinical and demographic characteristics of the patients age, gender, clinical symptoms, underlying conditions, predisposing factors, level of the abscess, causative organisms, preoperative motor status , treatments and outcomes were reviewed retrospectively. Levels of inflammatory markers white blood cell, C-reactive protein, and erythrocyte sedimentation rate and albumin were evaluated. Results: Seven 58.3% males and five 41.7% females, with a mean age of 65.7±8.6 years range, 56 to 82 years were evaluated in this study. The most common symptoms were back pain and motor weakness. The functional status of 4 patients 33.3% was unchanged after surgery, while seven patients 58.3% had functional improvements. Significant improvements were observed regarding blood levels of inflammatory markers and albumin after the treatments. Conclusion: The present study showed that surgical procedures have an important role in the management of SEA in patients with CRF.

Kaynakça

  • 1. Darouiche RO. Spinal epidural abscess. N Engl J Med 2006;355:2012-20
  • 2. Obrador GT, Levenson DJ. Spinal epidural abscess in hemodialysis patients: report of three cases and review of the literature. Am J Kidney Dis 1996;27:75-83
  • 3. Chima-Melton C, Pearl M, Scheiner, M. Diagnosis of spinal epidural abscess: a case report and literature review. Spinal Cord Ser Cases 2017;3:17013
  • 4. Chao D, Nanda A. Spinal epidural abscess: a diagnostic challenge. Am Fam Physician 2002;65:1341-6
  • 5. Reihsaus E, Waldbaur H, Seeling W. Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev 2000;23:175- 205
  • 6. Friedmand DP, Hills JR. Cervical epidural spinal infection; MR imaging characteristics. AJR Am J Roentgenol 1994;163:699- 704
  • 7. Kovalik EC, Raymond JR, Albers FJ, Berkoben M, Butterly DW, Montella B, et al. A clustering of epidural abscesses in chronic hemodialysis patients: Risks of salvaging access catheters in cases of infection. J Am Soc Nephrol 1996;7:2264-7
  • 8. Schoenfeld AJ, Wahlquist TC. Mortality, complication risk, and total charges after the treatment of epidural abscess. Spine J 2015;15:249-255
  • 9. Wong SS, Daka S, Pastewski A, Kyaw W, Chapnick E, Sepkowitz D. Spinal epidural abscess in hemodialysis patients: a case series and review. Clin J Am Soc Nephrol 2011;6:1495- 500
  • 10. Patel AR, Alton TB, Bransford RJ, Lee MJ, Bellabarba CB, Chapman JR. Spinal epidural abscesses: Risk factors, medical versus surgical management, a retrospective review of 128 cases. Spine J 2014;14:326-330
  • 11. Kang SJ, Jang HC, Jung SI, Choe PG, Park WB, Kim CJ, et al. Clinical characteristics and risk factors of pyogenic spondylitis caused by gram-negative bacteria. PLoS One 2015;10: e0127126
  • 12. Tsuchiya K, Yamaoka K, Tanaka K, Sasaki T. Bacterial spondylodiscitis in the patients with hemodialysis. Spine 2004;29:2533-2537
  • 13.Cheung WY, Luk KD. Pyogenic spondylitis. Int Orthop 2012;36:397-404
  • 14. Lu CH, Chang WN, Lui CC, Lee PY, Chang HW. Adult spinal epidural abscess: clinical features and prognostic factors. Clin Neurol Neurosurg 2002;104:306-10
  • 15.Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM. Bacterial spinal epidural abscess. Review of 43 cases and literature survey. Medicine 1992;71:369-85
  • 16. Khursheed N, Dar S, Ramzan A, Fomda B, Humam N, Abrar W, et al. Spinal epidural abscess: Report on 27 cases. Surg Neurol Int. 2017;8:240.
  • 17.DeFroda SF, DePasse JM, Eltorai AE, Daniels AH, Palumbo MA. Evaluation and management of spinal epidural abscess. J Hosp Med 2016;11;130-135
  • 18. Stratton A, Faris P, Thomas K. The prognostic accuracy of suggested predictors of failure of medical management in patients with nontuberculous spinal epidural abscess. Global Spine J 2018;8:279-285
Yıl 2019, Cilt: 5 Sayı: 3, 209 - 214, 01.07.2019
https://doi.org/10.5455/umj.20190719032811

Öz

Kaynakça

  • 1. Darouiche RO. Spinal epidural abscess. N Engl J Med 2006;355:2012-20
  • 2. Obrador GT, Levenson DJ. Spinal epidural abscess in hemodialysis patients: report of three cases and review of the literature. Am J Kidney Dis 1996;27:75-83
  • 3. Chima-Melton C, Pearl M, Scheiner, M. Diagnosis of spinal epidural abscess: a case report and literature review. Spinal Cord Ser Cases 2017;3:17013
  • 4. Chao D, Nanda A. Spinal epidural abscess: a diagnostic challenge. Am Fam Physician 2002;65:1341-6
  • 5. Reihsaus E, Waldbaur H, Seeling W. Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev 2000;23:175- 205
  • 6. Friedmand DP, Hills JR. Cervical epidural spinal infection; MR imaging characteristics. AJR Am J Roentgenol 1994;163:699- 704
  • 7. Kovalik EC, Raymond JR, Albers FJ, Berkoben M, Butterly DW, Montella B, et al. A clustering of epidural abscesses in chronic hemodialysis patients: Risks of salvaging access catheters in cases of infection. J Am Soc Nephrol 1996;7:2264-7
  • 8. Schoenfeld AJ, Wahlquist TC. Mortality, complication risk, and total charges after the treatment of epidural abscess. Spine J 2015;15:249-255
  • 9. Wong SS, Daka S, Pastewski A, Kyaw W, Chapnick E, Sepkowitz D. Spinal epidural abscess in hemodialysis patients: a case series and review. Clin J Am Soc Nephrol 2011;6:1495- 500
  • 10. Patel AR, Alton TB, Bransford RJ, Lee MJ, Bellabarba CB, Chapman JR. Spinal epidural abscesses: Risk factors, medical versus surgical management, a retrospective review of 128 cases. Spine J 2014;14:326-330
  • 11. Kang SJ, Jang HC, Jung SI, Choe PG, Park WB, Kim CJ, et al. Clinical characteristics and risk factors of pyogenic spondylitis caused by gram-negative bacteria. PLoS One 2015;10: e0127126
  • 12. Tsuchiya K, Yamaoka K, Tanaka K, Sasaki T. Bacterial spondylodiscitis in the patients with hemodialysis. Spine 2004;29:2533-2537
  • 13.Cheung WY, Luk KD. Pyogenic spondylitis. Int Orthop 2012;36:397-404
  • 14. Lu CH, Chang WN, Lui CC, Lee PY, Chang HW. Adult spinal epidural abscess: clinical features and prognostic factors. Clin Neurol Neurosurg 2002;104:306-10
  • 15.Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM. Bacterial spinal epidural abscess. Review of 43 cases and literature survey. Medicine 1992;71:369-85
  • 16. Khursheed N, Dar S, Ramzan A, Fomda B, Humam N, Abrar W, et al. Spinal epidural abscess: Report on 27 cases. Surg Neurol Int. 2017;8:240.
  • 17.DeFroda SF, DePasse JM, Eltorai AE, Daniels AH, Palumbo MA. Evaluation and management of spinal epidural abscess. J Hosp Med 2016;11;130-135
  • 18. Stratton A, Faris P, Thomas K. The prognostic accuracy of suggested predictors of failure of medical management in patients with nontuberculous spinal epidural abscess. Global Spine J 2018;8:279-285
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Research Article
Yazarlar

Arsal Acarbas

Yayımlanma Tarihi 1 Temmuz 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 5 Sayı: 3

Kaynak Göster

Vancouver Acarbas A. Spinal Epidural Abscess in Patients with Chronic Renal Failure: A Single-Center Experience. ULUTAS MED J. 2019;5(3):209-14.