Spinal Epidural Abscess

Abstract

A spinal epidural abscess is a collection of pus or inflammatory granulation tissue that is localized to the epidural space of the spinal cord. The abscess causes swelling in the area and threatens the spinal cord by compression and vascular disruption. The presence of a spinal epidural abscess is typically associated with a disk space infection or vertebral osteomyelitis. Common presenting symptoms include back pain, neurologic deficit, fever/chill, local tenderness, and paresthesias. Weakness or paralysis may not develop for many months or may occur suddenly and unpredictably in a matter of hours. Treatment goals for patients with spinal epidural abscess are eradication of infection, pain relief, preservation or improvement of neurologic status, and preservation of spinal stability. Laminectomy generally is the treatment of choice because the abscess is posterior in most patients. With surgery, most patients will recover fully or with minimal weakness.

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