Comment

Epidural abscess usually occurs as a complication of vertebral osteomyelitis or discitis, as in this case, and may cause nerve root or spinal cord compression. Prior to the era of MRI, diagnosis was by the invasive technique of myelography. Spinal infection may also spread anteriorly, leading to a retropharyngeal abscess in the cervical region, or psoas abscess in the lumbar spine (see Fig. 6.14). The condition is a neurosurgical emergency frequently requiring surgical drainage, decompression and stabilisation to prevent spinal cord infarction.

Fig. 6.14 Lumbar discitis and psoas abscess. Coronal STIR image sequence, this is a fat suppression sequence in which pathology usually appears high signal. In this example, the lumbar intervertebral disc and both adjacent vertebral bodies are of high signal. There is an abscess extending into the right psoas muscle.

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Essentials of Human Physiology

Essentials of Human Physiology

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