1990
DOI: 10.1227/00006123-199008000-00002
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Changing Concepts in Spinal Epidural Abscess: A Report of 29 Cases

Abstract: A review of our recent experience with spinal epidural abscess (SEA) reveals several important changing concepts in diagnosis, etiology, management, and outcome. All cases of SEA seen by our service from August 1975 to July 1989 were reviewed retrospectively, and 29 patients were identified (19 men and 10 women, aged 13-78 years). Abscesses were located in the lumbar (n = 21), thoracic (n = 7), and cervical (n = 1) epidural spaces. Gram-positive organisms were the infectious agent in 72% of the cases, and Stap… Show more

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Cited by 192 publications
(163 citation statements)
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“…6,9 Recent studies have attributed a rising incidence of spinal infection to increasing intravenous drug abuse. 2,3,5,7,10,12 Interestingly, none of our patients belonged to this high risk group. This may be because of the strict drug laws in Singapore and the sti penalties faced by drug addicts.…”
Section: Discussionmentioning
confidence: 66%
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“…6,9 Recent studies have attributed a rising incidence of spinal infection to increasing intravenous drug abuse. 2,3,5,7,10,12 Interestingly, none of our patients belonged to this high risk group. This may be because of the strict drug laws in Singapore and the sti penalties faced by drug addicts.…”
Section: Discussionmentioning
confidence: 66%
“…Over the 6-year study period, only 26 There are a few possible explanations for this: ®rstly, infections of the spine are uncommon and secondly, recent advances in imaging modalities, medical therapies and surgical techniques have resulted in improved clinical outcomes. 4,12 On the other hand, the mortality rate is high for those with severe disease or delayed diagnosis and treatment, and this group of patients often succumb to their illness or the complications thereof. 2,3 The study population (mean age=56.4 years) was generally older than the patients with traumatic spinal lesions rehabilitated at our centre (mean age=35 years).…”
Section: Discussionmentioning
confidence: 99%
“…8,20,21 However, radiological studies such as MRI may underestimate the severity of cord compression considerably. 14,22 Quite often the neurological picture seems not to be adequately explained by what looks like a small enhancing lesion on MRI. It is important to emphasize that the severity of neurological symptoms and potential cord damage does not correlate to the amount of visible compression.…”
Section: Surgery or Antibiotics?mentioning
confidence: 99%
“…18,23 Other factors, such as vascular compromise and spinal venous thrombosis are believed to contribute significantly. 2,3,19 Conventional myelography may still give a more adequate assessment in terms of the severity of cord compression in this entity, 7,14,22 especially if multiple spinal levels are involved. According to our experience, it is not possible to di erentiate between epidural granulomas and abscesses on MRI or any other radiographic study.…”
Section: Surgery or Antibiotics?mentioning
confidence: 99%
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