Abstract:
:Despite the increasing prevalence of spinal infections, the subcategory of holospinal epidural abscesses (HEAs) is extremely infrequent and requires unique management. Panspinal imaging (preferably MRI), modern aggressive antibiotic therapy, and prompt surgical intervention remain the standard of care for all spinal axis infections including HEAs; however, the surgical decision making on timing and extent of the procedure still remain ill defined for HEAs. Decompression including skip laminectomies or laminoplasties is described, with varied clinical outcomes. In this review the authors present the illustrative cases of 2 patients with HEAs who were treated using skip laminectomies and epidural catheter irrigation techniques. The discussion highlights different management strategies including the role of conservative (nonsurgical) management in these lesions, especially with an already identified pathogen and the absence of mass effect on MRI or significant neurological defects. Among fewer than 25 case reports of HEA published in the past 25 years, the most important aspect in deciding a role for surgery is the neurological examination. Nearly 20% were treated successfully with medical therapy alone if neurologically intact. None of the reported cases had an associated cranial infection with HEA, because the dural adhesion around the foramen magnum prevented rostral spread of infection. Traditionally a posterior approach to the epidural space with irrigation is performed, unless an extensive focal ventral collection is causing cord compression. Surgical intervention for HEA should be an adjuvant treatment strategy for all acutely deteriorating patients, whereas aspiration of other infected sites like a psoas abscess can determine an infective pathogen, and appropriate antibiotic treatment may avoid surgical intervention in the neurologically intact patient.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Smith GA,Kochar AS,Manjila S,Onwuzulike K,Geertman RT,Anderson JS,Steinmetz MPdoi
10.3171/2014.5.FOCUS14136subject
Has Abstractpub_date
2014-08-01 00:00:00pages
E11issue
2issn
1092-0684journal_volume
37pub_type
杂志文章abstract::For a physician has the worth of many other warriors, both for the excision of arrows and for the administration of soothing drugs. Homer, Iliad XI.514-515 Ever since armed conflict has been used as a means to settle disputes among men, there have been those who have been tasked to mend the wounds that ravage a soldie...
journal_title:Neurosurgical focus
pub_type: 历史文章
doi:10.3171/2010.3.FOCUSMar2010Intro
更新日期:2010-05-01 00:00:00
abstract::There are many options for the surgical treatment of lumbar spondylolisthesis, including anterior and posterior techniques. Among the most versatile is a 360 degrees fusion. In consideration of the added risk of morbidity of two procedures, circumferential fusion leads to the highest fusion rates. This is particularly...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
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abstract:OBJECT:The aim of this study was to analyze the national health care burden of patients diagnosed with epilepsy in the US and to analyze any changes in the length of stay, mean charges, in-hospital deaths (mortality), and disposition at discharge. METHODS:A retrospective review of the Nationwide Inpatient Sample (NIS)...
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pub_type: 杂志文章
doi:10.3171/2012.1.FOCUS11322
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
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journal_title:Neurosurgical focus
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doi:
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journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.9.FOCUS09191
更新日期:2009-12-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC/2008/25/9/E19
更新日期:2008-09-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC/2008/24/2/E14
更新日期:2008-01-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/2020.3.FOCUS20114
更新日期:2020-06-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2013.2.FOCUS12397
更新日期:2013-04-01 00:00:00
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pub_type: 杂志文章
doi:10.3171/2020.2.FOCUS207
更新日期:2020-05-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.V3.FOCUS14155
更新日期:2014-09-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 社论
doi:10.3171/2012.5.FOCUS12127
更新日期:2012-07-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 临床试验,杂志文章
doi:
更新日期:2006-04-15 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.4.FOCUS10296
更新日期:2011-06-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/24/1/E2
更新日期:2008-01-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.4.FOCUS20185
更新日期:2020-07-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2005.18.3.11
更新日期:2005-03-15 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2013.11.FOCUS13475
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC-07/10/E3
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.2.FOCUS1164
更新日期:2011-06-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.1.FOCUS09303
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2018.5.FOCUS18163
更新日期:2018-08-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2017.3.FOCUS16427
更新日期:2017-06-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2016.7.FOCUS16191
更新日期:2016-09-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2019.6.FOCUS19337
更新日期:2019-09-01 00:00:00
abstract::Deep brain stimulation (DBS) is the treatment of choice for otherwise healthy patients with advanced Parkinson disease who are suffering from disabling dyskinesias and motor fluctuations related to dopaminergic therapy. As DBS is an elective procedure, it is essential to minimize the risk of morbidity. Further, precis...
journal_title:Neurosurgical focus
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doi:10.3171/2010.4.FOCUS10103
更新日期:2010-08-01 00:00:00
abstract::A historical review is presented of the original descriptions of lumbar discectomy, focusing on the evolution toward a less invasive surgical approach following the introduction of the operating microscope. From the initial work in Europe by Yasargil and Caspar to the popularization of microdiscectomy by Williams and ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2002.13.2.4
更新日期:2002-08-15 00:00:00
abstract::The authors detail the life and career of Dr. J. Lawrence Pool, as well as his significant contributions to the field of cerebrovascular neurosurgery. The discipline of cerebrovascular neurosurgery is a young and dynamic field, which underwent rapid and substantial growth during the middle of the twentieth century. As...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
doi:
更新日期:2006-06-15 00:00:00
abstract::Since the development of the WHO Safe Surgery Saves Lives initiative and Surgical Safety Checklist, numerous hospitals across the globe have adopted the use of a surgical checklist. The UCLA Health System developed its first extended Surgical Safety Checklist in 2008. Authors of the present paper describe how the time...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
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更新日期:2012-11-01 00:00:00