MANAGEMENT OF A SPONTANEOUS SPINAL EPIDURAL ABSCESS

• DOI: 10.1227/01.neu.0000356972.97356.c5
• Publication Date: 2009-10-15T07:29:10Z
• Authors: Isaac O. Karikari; Ciaran J. Powers; Renee M. Reynolds; Ankit I. Mehta; Robert E. Isaacs
• Keywords: Spinal Epidural Abscess; Intravenous antibiotics; Spinal decompression; Conservative Management

There is significant debate in the literature regarding optimal management of patients with diagnosis a spinal epidural abscess (SEA). Although some have advocated conservative treatment intravenous antibiotics alone select patients, recent studies shown that treated without early surgery are more likely to poor outcomes.In this study, we review at tertiary medical center spontaneous SEA. A total 104 had an SEA over 10-year period. More than half these presented back pain and no objective motor weakness. Sixty-four (61.5%) were conservatively computed tomography-guided aspiration or based on blood cultures, whereas 40 (38.5%) underwent surgical decompression.Of managed nonoperatively, 11% improved, 64% remained stable, 17% died. Conversely, surgery, 25% 43% 23% Review imaging revealed 65.4% ventral SEA, 34.6% dorsal there statistically differences between 2 groups terms outcome, 30.6% paraplegic quadriplegic, only 7.3% quadriplegic (P = 0.003).Our data do not support hypothesis outcome. Furthermore, propose anatomy (ventral dorsal) should play important role determining plan.