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Quadriplegia with Cervical Pyogenic Spondylitis : Case Report Takeaki Ueno 1 , Yoshihide Masuda 1 , Hiroyuki Shimaoka 1 , Hutosi Miura 1 , Katsuya Ito 1 , Kazunori Yoshimura 1 , Mikio Shimobayashi 2 1Department of Orthopaedic Surgery, Ohyodo Hospital 2Department of Orthopeadic Surgery, Nara Prefectural Hospital Keyword: pyogenic spondylitis , 化膿性脊椎炎 , quadriplegia , 四肢麻痺 , MRI , 磁気共鳴画像 pp.1461-1465
Published Date 2004/11/1
DOI https://doi.org/10.11477/mf.1408100582
  • Abstract
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 A 50-year-old female rheumatoid arthritis (RA) patient was admitted for neck pain and a slight fever, and she developed tetraparesis on the 3rd hospital day. A magnetic resonance imaging (MRI) study showed a high-signal-intensity area in the epidural space from C4 to C7 and in the C6/7 disk space, suggesting that the tetraparesis was secondary to cord compression by an epidural abscess in the acute stage of a pyogenic spinal infection. The patient's general condition was so poor that we abandoned surgery and chose conservative therapy consisting of bed rest and antibiotics. Six months after admission she had almost fuly recovered and was able to walk with a cane.

 Epidural abscess should be considered in any RA patient with painful spinal symptoms associated with fever.


Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1286 印刷版ISSN 0557-0433 医学書院

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