Akademik Veri Yönetim Sistemi
XVI. Uluslararası Türk Omurga Kongresi, Muğla, Türkiye, 22 - 25 Mayıs 2025, ss.137-138, (Özet Bildiri)
Aim: Acute central cord syndrome (CCS) is a well-known clinical pattern of spinal cord injury (SCI) defi ned as a spinal lesion causing quadriparesis with relatively greater weakness in the hands and forearms than in the upper arms and legs. CCS is the most common type of incomplete SCI, comprising 15% to 25% of all cases. Acute CCS is typically seen in older patients with cervical spondylosis or younger patients with congenital cervical spinal canal stenosis who sustain a hyperextension injury. Trauma is the most common cause of CCS. However, CCS can also result from nontraumatic causes, such as cervicall epidural abscess. In this report, we present a case of acute CSS arising from a cervical epidural abscess in a 35-year-old woman and report the clinical, radiologic, and surgical fi ndings with follow-up results. To the authors’ knowledge, this is the second case of acute CSS caused by cervical epidural abscess reported in the literature.
Material and Method: A 35-year-old woman presented to the emergency department with complaints of severe neck pain, bilateral radiculopathy, hand weakness, numbness, and urinary retention. She had a total thyroidectomy 2 weeks ago. On neurologic examination, the patient was quadriparetic with upper extremity proximal 3/5 distal 2/5 and lower extremity 4/5. Cervical magnetic resonance imaging (MRI) revealed a 35.7x35x9.7 mm thick-capsulated collection in the epidural space at the C3-C5 level, consistent with an abscess causing cord compression and spinal canal narrowing. The abscess was highly signalized on T1-weighted sections (T1W) and was contrast-enhanced when contrast was applied. The patient with CRP: 66 mg/L, leukocyte: 21.100 u/L, hemoglobin: 10.1 g/dL, TSH: 50.2 m(IU)/L, fT3: 1.81 pg/mL, calcium: 7.02 mg/dL was taken to surgery.Epidural abscess on axial T1W contrast-enhanced MRI through
the C4-5 disc level
Findings: Abscess drainage was performed through an anterior approach at the C4-5 level. Serratia marcescens and Serratia nematodiphilia grew from the abscess material. In addition, the urine culture also grew Serratia marcescens. The patient was given triple IV antibiotherapy for 4 weeks, oral single antibiotherapy for 8 weeks. The patient’s neurologic defi cit improved, and she mobilized within one week and all preoperative complaints were resolved. At the 9th month postoperative follow-up, the patient had no complaints, and neurologic examination was normal. Control cervical MRI showed no epidural abscess, and control cervical computed tomography did not show any instability problem.
Result: Cervical epidural abscess is one of the causes of nontraumatic CCS and surgery should be performed as early as possible for good outcome.