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  4. Emergency surgery for a patient with a thoracic spinal epidural abscess: a case report and literature review

Emergency surgery for a patient with a thoracic spinal epidural abscess: a case report and literature review

Journal of International Medical Research, 2023 · DOI: 10.1177/03000605231168757 · Published: April 1, 2023

ImmunologySurgeryTrauma

Simple Explanation

A man in his early 40s experienced sudden lower limb weakness and was diagnosed with a thoracic spinal epidural abscess (SEA). Doctors performed emergency surgery to relieve pressure on his spinal cord. Post-surgery, the patient received antibiotics and rehabilitation. Within four weeks, he regained full strength in his legs. The case highlights the importance of quick diagnosis, surgery, and rehabilitation for successful recovery from thoracic SEA.

Study Duration
13 months of follow-up
Participants
One man in his early 40s
Evidence Level
Level 4: Case Report and Literature Review

Key Findings

  • 1
    Timely diagnosis and surgical intervention within 24 hours of paralysis are crucial for recovering lower limb muscle strength in thoracic SEA cases.
  • 2
    Postoperative anti-infection management with appropriate antibiotics, guided by bacterial culture results, is essential for successful treatment.
  • 3
    Rehabilitation exercises play a significant role in the full recovery of lower limb muscle strength after surgical decompression.

Research Summary

This case report details the successful emergency surgical management of a thoracic spinal epidural abscess (SEA) in a man in his early 40s who presented with acute lower limb paralysis. The patient underwent a thoracic laminectomy and debridement within 24 hours of paralysis, followed by targeted antibiotic therapy based on bacterial culture results, and a rehabilitation program. Within four weeks post-surgery, the patient regained full muscle strength in his lower limbs, emphasizing the importance of early diagnosis, prompt surgical intervention, appropriate antibiotic management, and rehabilitation.

Practical Implications

Early Diagnosis

Clinicians should maintain a high index of suspicion for SEA in patients presenting with back pain and neurological deficits, especially those with risk factors.

Rapid Intervention

Emergency surgical decompression should be performed as quickly as possible to prevent permanent neurological damage.

Comprehensive Management

Postoperative care should include targeted antibiotic therapy and a structured rehabilitation program to maximize functional recovery.

Study Limitations

  • 1
    Single case report limits generalizability.
  • 2
    Lack of enhanced MRI data.
  • 3
    Limited follow-up period.

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