頸椎より腰椎まで21椎間におよぶ脊髄硬膜外膿瘍の1例

A Case of Spinal Epidural Abscess Extending over Twenty-one Vertebral Levels from Cervical through Lumbar Spines

I．はじめに

　脊髄硬膜外膿瘍は古くから知られ，早期診断の重要性が繰返し指摘されているにもかかわらず，診断は今なお重篤な神経症状を呈してからなされ，近年の報告をかんがみても，その治療成績は満足すべきものではなく死亡率も高い^2,24,27）．著者らは最近，糖尿病を背景とし背部痛より始まり，四肢麻痺，呼吸困難，麻痺性イレウスを呈した頸椎より腰椎まで21椎間におよぶ脊髄硬膜外膿瘍の1例を経験し，椎弓切除術による排膿および大量の抗生物質の投与により良好な結果を得たので報告する．

Purulent inflammatory disorders within the spinal canal are considered to be rare, comparing with those within the cranium. Although spinal epidural abscess is a well-known condition and the importance of its early detection is repeatedly stressed, most of the cases were diagnosed only after the appearance of serious neurological problems. The mortality in this disorder has been relatively high, the prognosis being fairly poor. We are reporting the successful treatment of a patient who was in critical condition with quadriparesis, spinal ileus and respiratory distress because of an extensive spinal epidural abscess.