Operative Therapie intraspinaler Empyeme: Eine retrospektive Untersuchung von 23 Patienten

Abstract

Intraspinal empyema is a rare entity in spinal surgery. This study analyses the results after operating in 23 patients. This is a retrospective study of 23 patients suffering from intraspinal empyema treated operatively in our department. The data were obtained by analysing the patient documents including the radiological and microbiological data. 18 patients suffered from different neurological deficits ranging from isolated mild hypaesthesia to paraplegia (n = 3). The operation was done as a one-level (n = 13), two-level (n = 8)or three-level (n = 2) microsurgical fenestration followed by irrigation and drainage of the pus. Staphylococcus aureus was the most frequent triggering organism. After a follow-up of 7 months 1 patient had died because of septic complications. Neurological deficits improved in 14 patients but 3 patients were still disabled in their daily life. Epidural spinal empyema remains a challenge in spine surgery. Persistent neurological deficits and lethal complications make it a severe problem. Management comprises urgent surgical evacuation of the pus followed by targeted antibiotic therapy.