Spinal epidural abscesses: A retrospective analysis of clinical manifestations, sources of infection, and outcomes

Hsien Chih Chen, Wen Ching Tzaan, Tai Ngar Lui

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Spinal epidural abscess (SEA) is uncommon but has a potentially disastrous outcome. Its early recognition and management may lead to satisfactory results. We analyzed the clinical manifestations, sources of infection, and outcomes of patients with SEA. Methods: Between 1997 and 2003, 17 patients in the Department of Neurosurgery at Keelung Chang Gung Memorial Hospital had SEA. We retrospectively reviewed their records to analyze their clinical presentations, image findings, laboratory data, and clinical outcomes. Results: All 17 patients (mean age, 63 years) underwent surgery and received antibiotics. Back and/or neck pain (82%), motor deficits (70%), and elevated C-reactive protein levels or erythrocyte sedimentation rates (64%) were the most common symptoms and signs. The most common etiological organism was oxacillin-resistant Staphylococcus aureus. The SEA was most commonly located in the lumbar spine, anterior to the spinal canal. Outcomes were poor in 29% of the patients, fair in 18%, and good in 53%. Conclusions: Abdominal complications in patients with spinal disease are not uncommon, especially when the thoracic level is involved. The abdominal symptoms may initially mask neurological deficits due to spinal cord involvement, however, spinal pain and motor deficits present in most cases under more thorough investigation. In a suspected SEA patient with a history of gouty arthritis, tissue biopsy should include additional crystal analysis. Although the increasing availability of MRI makes diagnosis easier and quicker, repeated neurological examination and full evaluation are essential in any patient with an unknown focus of infection and spinal pain or tenderness.

Original languageEnglish
Pages (from-to)351-358
Number of pages8
JournalChang Gung Medical Journal
Volume27
Issue number5
Publication statusPublished - May 2004
Externally publishedYes

Fingerprint

Epidural Abscess
Infection
Gouty Arthritis
Spinal Diseases
Pain
Oxacillin
Spinal Canal
Neck Pain
Blood Sedimentation
Neurologic Examination
Neurosurgery
Back Pain
Masks
C-Reactive Protein
Signs and Symptoms
Staphylococcus aureus
Spinal Cord
Spine
Thorax
Anti-Bacterial Agents

Keywords

  • Clinical manifestations
  • Outcomes
  • Sources of infection
  • Spinal epidural abscess

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Spinal epidural abscesses : A retrospective analysis of clinical manifestations, sources of infection, and outcomes. / Chen, Hsien Chih; Tzaan, Wen Ching; Lui, Tai Ngar.

In: Chang Gung Medical Journal, Vol. 27, No. 5, 05.2004, p. 351-358.

Research output: Contribution to journalArticle

Chen, Hsien Chih ; Tzaan, Wen Ching ; Lui, Tai Ngar. / Spinal epidural abscesses : A retrospective analysis of clinical manifestations, sources of infection, and outcomes. In: Chang Gung Medical Journal. 2004 ; Vol. 27, No. 5. pp. 351-358.
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