A Diagnostic Pitfall; Anterior Spinal Epidural Abscess Mimicking Lumbar Disc Herniation
Journal Title: Journal of Neurological Sciences-Turkish - Year 2006, Vol 23, Issue 2
Abstract
Introduction: Spinal epidural abscess (SEA) is very rare patology. Clinical presentation of spinal epidural abscess varies according to affected spinal level. Diagnosis of SEA may be difficult because of nonspesific clinical features, may mimic a number of diseases effecting epidural space. Case report: A 31-year-old female admitted to hospital with 1 month history of right tight pain which radiated down to her right leg. She had suffered of incontinance for 4 days. Physical examination showed no abnormality. Neurological examination revealed only (+) laseque test at 45 degrees on right lower extremity. Magnetic Resonance images demostrated disc protrusion related an epidural mass located anteriorly at L5-S1 disc level epidural abscess was observed to be located just under the S1 root peroperatively. Blood cultures and speciment cultures were negative. Discussion: SEA occurs in 0.2-2.8 per 10.000 hospital admissions in general hospitals. SEA may mimic the lomber disc herniations which are most frequent diagnosed disease in neurosurgical pratice. SEA is a devastating illness if not treated promptly. It is difficult to distinguish it from lomber disc herniation unless accompaning phycical signs like local tenderness, fever and laboratory findings like leucocytosis and elevated sedimentation rate.
Authors and Affiliations
Bekir TUGCU, Bulent DEMIRGIL, Omur GUNALDI, Baris COLLUOGLU, Murat GUNAL, Utku ADILAY
Keywords
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