Preoperative MR diagnosis of spinal subdural empyema-secondary to osteomyelitis and epidural empyema

Only few cases of spinal subdural empyema has been reported in the literature and the preoperative diagnosis is much less. Due to the advance of magnetic resonance imaging techniques, we reported a 75 years old female with spinal subdural empyema. She was a diabetic patient and received laminectomy, complicated with vertebral body osteomyelitis about 15 years ago at the 4th and 5th vertebral body of lumbar region (L4/5). She is a victim of cervical cancer and currently suffered from leukocytosis, high fever and then low back pain for several weeks. Magnetic resonance imaging clearly depicts the picture of osteomyelitis at L4/5 with mixed epidural and subdural abscess. The subdural lesion extended upwardly from L4 to T11 (the 11th vertebrae of thoracic spine) level. Laminectomy and durectomy were performed soon and clearly revealed the picture of long segment subdural abscess. Post-operation recovery course is fine.