Epidural abscess surgery: What you need to know

Epidural abscess is a disease caused by a mass of pus located between the epidural space and the spinal canal. The cause of the disease is infection such as tuberculosis of the spine, infection after surgery, ... If the disease is not diagnosed and treated, it will lead to the risk of paralysis and permanent disability.

1. How dangerous is an epidural abscess?

In the world, epidural abscess is rare. However, in Vietnam, this disease is quite common due to the increasing trend of tuberculosis. The cause of the disease is due to distant infections or adjacent infections such as tuberculosis of the spine, infection after spinal interventions, abscesses can also be caused by infection from other places such as after infection. ,...
Depending on the location and degree of compression of the abscess, the manifestation of paralysis can be in the lower limbs or in both arms and legs with levels ranging from mild to severe such as decreased sensation, decreased movement to loss of movement and complete loss of sensation.
Hình ảnh áp xe ngoài màng tủy trên phim CT
Hình ảnh áp xe ngoài màng tủy trên phim CT

Besides, the patient can have bowel and urinary disorders, even respiratory disorders and can lead to death. The cause of the patient's paralysis is due to an abscess directly pressing on the spinal cord, also known as a cerebrospinal abscess, or due to an infection that causes an embolism, causing ischemia of the spinal cord, causing damage to the spinal cord.

2. Extramembranous abscess surgery

2.1. Indications and contraindications for surgery for epidural abscess Indications for surgery for epidural abscess when: failure of medical treatment; compression injury on 4 vertebrae; widespread lesions with symptoms of paralysis and decreased sensation; Surgery is contraindicated when: Patients with severe coagulopathy, anesthesia is not warranted.
Rối loạn đông máu
Người bệnh rối loạn đông máu thuộc nhóm đối tượng chống chỉ định

2.2. Steps of extramedullary abscess surgery Step 1: Diagnose, test, and evaluate the patient's condition. Step 2: Prepare surgical instruments, drugs, fluids... Step 3: Anesthetize the patient. Step 4: Carry out surgery: Make an incision in the midline of the back through the location of the abscess, then separate the paraspinal muscle fascia, then open the posterior arch at the location of the abscess, flush with plenty of water and hydrogen peroxide to suck the tissue. inflammation, necrosis, microbiological examination and surgical drainage placement. Step 5: Close the incision and treat with broad-spectrum antibiotics, combination, and encirclement. After surgery for extramedullary abscess, it is necessary to monitor pulse, blood pressure, incision and take care of daily dressing change, and manage complications if any such as bleeding, infection.

Epidural abscess is a dangerous disease that, if not examined and treated early, will lead to the risk of permanent disability. In particular, extramedullary abscess surgery is one of the complex surgeries requiring high expertise, so patients need to choose to be examined and treated at reputable facilities to ensure quality.

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Vinmec International General Hospital is an address for examination, consultation, treatment and prevention of many diseases, featuring modern medical equipment and quality medical services, helping to detect and treat effectively. disease outcomes.
To register for examination and treatment at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or register online HERE.

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