| Abstrakt: |
Twelve children under the age of 14 years were operated upon for acute epidural abscess during the period 1968–1990. Four presented with abdominal pain and tenderness, 2 with pain in the back attributed to local trauma, 3 had a sudden simultaneous onset of back pain and paraplegia, 1 developed quadriplegia after drainage of tibial osteitis, 1 was suspected of having meningitis, and the only infant in this series presented with weakness of one arm. White cell counts and erythrocyte sedimentation rates were invariabaly raised. Myelography or cisternography identified the block in 6 children and failed in 3. MRI proved useful in the last 2 patients. The epidural abscesses were always situated in the posterior epidural space: 5 thoracic, 6 lumbosacral, and 1 in the lower cervical and thoracic areas. Two-to three-level laminectomies were done in all 12 children with the insertion of soft rubber catheters and post-operative antibiotic irrigation in 6. The organism in each instance was a penicillin-resistant Staphylococcus aureus. Seven children were neurologically normal post-operatively; 3 of these had been normal prior to surgery. Of the reamining 4 children who recovered completely, 3 had had their neurological signs for less than 24 h. Two children were left completely paraplegic and 1 was confined to a wheelchair with grade 2/5 weakness in the lower limbs. Two others were functional, but with minor neurological loss. All children left with neurological handicaps had had delays of more than 36 h from the onset of their neurological signs to surgery. |
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