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Spinal holocord epidural abscess evacuated with double thoracic interval laminectomy: a rare case report with literature review

INTRODUCTION: Holocord spinal cord epidural abscess is an uncommon condition that may result in serious neurological complications. Prompt diagnosis and early treatment is of paramount importance for an optimum clinical outcome. This case report describes a novel technique of interval laminectomy at...

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Autores principales: Ahuja, Kaustubh, Das, Lakshmana, Jain, Aakriti, Meena, Pradeep Kumar, Arora, Shobha S., Kandwal, Pankaj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6786417/
https://www.ncbi.nlm.nih.gov/pubmed/31632720
http://dx.doi.org/10.1038/s41394-019-0206-8
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author Ahuja, Kaustubh
Das, Lakshmana
Jain, Aakriti
Meena, Pradeep Kumar
Arora, Shobha S.
Kandwal, Pankaj
author_facet Ahuja, Kaustubh
Das, Lakshmana
Jain, Aakriti
Meena, Pradeep Kumar
Arora, Shobha S.
Kandwal, Pankaj
author_sort Ahuja, Kaustubh
collection PubMed
description INTRODUCTION: Holocord spinal cord epidural abscess is an uncommon condition that may result in serious neurological complications. Prompt diagnosis and early treatment is of paramount importance for an optimum clinical outcome. This case report describes a novel technique of interval laminectomy at two sites in the thoracic spine and surgical decompression with the help of infant feeding tubes in a case of holocord spinal epidural abscess (HSEA). CASE PRESENTATION: An 18-year-old male presented to the emergency department with high-grade fever and low back ache of 2 weeks duration and loss of bowel and bladder control for 4 days. Neurological examination revealed intact motor power and sensation in all four limbs at presentation; however, there was a rapid deterioration to complete quadriplegia within 24 h. A diagnosis of holocord epidural abscess was made. Emergent decompression via interval thoracic laminectomy was done and appropriate antimicrobial therapy was instituted. At 10 months of follow-up, the individual showed complete neurological recovery. DISCUSSION: The technique used in this case is unique with respect to the level of laminectomy and the manoeuvre employed for pus evacuation. Complete neurological and functional recovery was achieved despite complete paralysis pre-operatively. The outcome indicates that there may be good prognosis for individuals with HSEA accompanied with neurological deficit and emergent surgical decompression.
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spelling pubmed-67864172020-07-02 Spinal holocord epidural abscess evacuated with double thoracic interval laminectomy: a rare case report with literature review Ahuja, Kaustubh Das, Lakshmana Jain, Aakriti Meena, Pradeep Kumar Arora, Shobha S. Kandwal, Pankaj Spinal Cord Ser Cases Case Report INTRODUCTION: Holocord spinal cord epidural abscess is an uncommon condition that may result in serious neurological complications. Prompt diagnosis and early treatment is of paramount importance for an optimum clinical outcome. This case report describes a novel technique of interval laminectomy at two sites in the thoracic spine and surgical decompression with the help of infant feeding tubes in a case of holocord spinal epidural abscess (HSEA). CASE PRESENTATION: An 18-year-old male presented to the emergency department with high-grade fever and low back ache of 2 weeks duration and loss of bowel and bladder control for 4 days. Neurological examination revealed intact motor power and sensation in all four limbs at presentation; however, there was a rapid deterioration to complete quadriplegia within 24 h. A diagnosis of holocord epidural abscess was made. Emergent decompression via interval thoracic laminectomy was done and appropriate antimicrobial therapy was instituted. At 10 months of follow-up, the individual showed complete neurological recovery. DISCUSSION: The technique used in this case is unique with respect to the level of laminectomy and the manoeuvre employed for pus evacuation. Complete neurological and functional recovery was achieved despite complete paralysis pre-operatively. The outcome indicates that there may be good prognosis for individuals with HSEA accompanied with neurological deficit and emergent surgical decompression. Nature Publishing Group UK 2019-07-02 /pmc/articles/PMC6786417/ /pubmed/31632720 http://dx.doi.org/10.1038/s41394-019-0206-8 Text en © International Spinal Cord Society 2019
spellingShingle Case Report
Ahuja, Kaustubh
Das, Lakshmana
Jain, Aakriti
Meena, Pradeep Kumar
Arora, Shobha S.
Kandwal, Pankaj
Spinal holocord epidural abscess evacuated with double thoracic interval laminectomy: a rare case report with literature review
title Spinal holocord epidural abscess evacuated with double thoracic interval laminectomy: a rare case report with literature review
title_full Spinal holocord epidural abscess evacuated with double thoracic interval laminectomy: a rare case report with literature review
title_fullStr Spinal holocord epidural abscess evacuated with double thoracic interval laminectomy: a rare case report with literature review
title_full_unstemmed Spinal holocord epidural abscess evacuated with double thoracic interval laminectomy: a rare case report with literature review
title_short Spinal holocord epidural abscess evacuated with double thoracic interval laminectomy: a rare case report with literature review
title_sort spinal holocord epidural abscess evacuated with double thoracic interval laminectomy: a rare case report with literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6786417/
https://www.ncbi.nlm.nih.gov/pubmed/31632720
http://dx.doi.org/10.1038/s41394-019-0206-8
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