| The sacral hiatus approach for drainage of anterior lumbo-sacral epidural abscesses. A case report and technical note. | |
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MedLine Citation:
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PMID: 22192554 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Lumbosacral epidural abscesses are managed either conservatively with IV antibiotics or with open surgery, particularly in the presence of acute neurological symptoms. Their location makes it difficult for image-guided interventional approaches either for biopsy or evacuation. We report the sacral hiatus and canal as a corridor for image-guided minimally invasive abscess of lumbosacral epidural abscess for aspiration. A 56-year-old man presented to the emergency department complaining of six weeks of worsening low back pain. MRI of the patient's lumbosacral spine showed osteomyelitis involving his L5, S1 vertebrae, L5-S1 discitis, as well as an anterior epidural abscess extending from L4-5 disc space to the S2 vertebral level. Blood cultures grew out gram-positive cocci. For drainage, a 5-French micropuncture kit was utilized to access the hiatus. Under fluoroscopic guidance a microwire was then advanced along the sacral canal. An 18-gauge needle curved to approximate the contours of the sacral canal was then advanced over the guidewire. Once anatomic access was established 2 ml of thick purulent material was aspirated. The patient tolerated the procedure well, and no focal nerve root symptoms were noted following the procedure. Image-guided aspiration of lumbosacral epidural abscesses can thus be carried out in a safe and effective manner using a sacral hiatus approach. |
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Authors:
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Marlon S Mathews; J Ospina; S Suzuki |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2011-12-16 |
Journal Detail:
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Title: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Volume: 17 ISSN: 1591-0199 ISO Abbreviation: Interv Neuroradiol Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-23 Completed Date: 2012-03-01 Revised Date: 2012-05-02 |
Medline Journal Info:
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Nlm Unique ID: 9602695 Medline TA: Interv Neuroradiol Country: Italy |
Other Details:
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Languages: eng Pagination: 482-5 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, University of California, Irvine, CA, USA. mmathews@uci.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Contrast Media
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diagnostic use Drainage / methods* Epidural Abscess / surgery* Humans Magnetic Resonance Imaging, Interventional Male Middle Aged Sacrum / surgery* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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