A Cervical Epidural Abscess Diagnosed by Magnetic Resonance Imaging : A Case Report and a Review of the Literature

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  • 頸髄硬膜外膿瘍の1手術例

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Reported herein is a case of a cervical epidural abscess in a 69-year-old female who was hospitalized for quadriplegia and who underwent anterior cervical debridement with an autogenous iliac bone graft. Although the results of a plain cervical X ray were negative, magnetic resonance imaging (MRI) revealed an anterior epidural mass compressing the C4-C5 region that showed a decreased signal intensity on T1-weighted imaging (T1WI) but a markedly increased signal intensity on gradient echo imaging (GEI) . The disc signal intensity of the C4-C5 region was slightly decreased on T1WI but increased on GEI. Further the body signal intensity of the C4 and C5 region was also increased on GEI. Because of these findings the diagnosis was a cervical epidural abscess complicated by discitis and osteomyelitis. The patient underwent anterior cervical decompression with fusion, and the neurological results were satisfactory. The pertinent literature is reviewed and 9 such cases in Japan are discussed. The usefulness of MRI is stressed for selections anterior surgery as a means of treatment and methods of abscess curettage are discussed.

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