Vertebral column actinomycotic infection complicated with spinal cord compression:report of three cases / 临床神经病学杂志

ABSTRACT

Objective To investigate the clinical, radiological features and therapy of spinal actinomycotic infection complicated with spinal cord compression.Methods The data of three patients confirmed by histopathology were analyzed retrospectively.Results All three patients presented with infection of cervical thoracal vertebral bodies and soft tissue, and with syndrome of spinal cord compression. MRI examination revealed destruction of vertebral bodies, extradural soft tissue mass and spinal cord compression. Histopathological examination confirmed the infection of actinomycete in all three patients. Granulomatous inflammation could be seen in two cases, while extradural abscess was found in the other one case. Three patients all received the operation of abscess draining and vertebral canal decompression. Large-dose of Penicillin G following operation was administrated intravenously for 4～8 weeks, and then changed to oral application for another 4～6 months. Follow-up showed significant clinical effect in these three patients.Conclusions Radiologic and clinical findings of spinal actinomycotic infection complicated with spinal cord compression are nonspecific, and the diagnosis of this disease depends on pathological and microbiologic exams. Treatments with abscess draining, vertebral canal decompression and large-dose of antibiotic may achieve good clinical outcome.