Spinal epidural abscess: A report of 40 cases and review

Nussbaum, Eric S.; Rigamonti, Daniele; Standiford, Harold C.; Numaguchi, Yuji; Wolf, Aizik L.; Robinson, Walker L.

doi:10.1016/0090-3019(92)90173-k

Cited by 266 publications

(228 citation statements)

References 26 publications

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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: 65%

“…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). This is probably because many of the conditions that predispose to a spinal infection are more prevalent in older patients.…”

Section: Discussionmentioning

confidence: 99%

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Infectious disease of the spine: outcome of rehabilitation

1998

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Infectious disease of the spine is infrequently seen in the rehabilitation setting. We examined retrospectively 26 patients with spinal infections admitted to the rehabilitation centre over a 6-year period to determine the demographic characteristics, clinical features and outcome after rehabilitation.Their ages ranged from 24 to 83 years (mean=56.4); 65.4% were males. The infection was due to pyogenic bacteria in 14 patients (53.8%) and Mycobacterium tuberculosis in 12 (46.2%). Staphylococcus aureus was the causative agent in 69% of those with pyogenic infections. A history of diabetes mellitus was present in 35.7% of the pyogenic group but in only 8.3% of the tuberculous group. Localised back pain, fever and neurological de®cits were the typical clinical manifestations. The most common site of infection was the thoracic region. Surgery was performed on 24 patients and all received prolonged courses of antibiotics.All but three patients completed the rehabilitation programme. The motor score for the lower limbs and the modi®ed Barthel scores for activities of daily living (ADL) and mobility improved signi®cantly (P50.05) for both pyogenic and tuberculous groups. The amounts of improvement achieved were not signi®cantly di erent between the pyogenic and tuberculous groups except for ADL. Age, gender and the presence of diabetes mellitus did not appear to signi®cantly a ect the neurological or functional outcome in our study population. The majority of patients (87.5%) were discharged to their own homes.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Infectious disease of the spine: outcome of rehabilitation

1998

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“…An abnormality of the vertebral column and trauma of the spine are also risk factors (4). Among them, DM is one of the most common predisposing factors (5)(6)(7)(8). In the present case, the patient also had poorly controlled DM.…”

Section: Discussionmentioning

confidence: 61%

Cervical Epidural Abscess Presenting with Brown-Sequard Syndrome in a Patient with Type 2 Diabetes

et al. 2010

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An 80-year-old woman with type 2 diabetes was admitted due to right-handed muscle weakness. The patient presented with Brown-Sequard syndrome, with complete paralysis of the right lower limb along with a loss of pain and temperature sensations in the left lower limb. Magnetic resonance imaging revealed a cervical epidural abscess, and accompanying edema or inflammation of the right side of the spinal cord at the C5 level. She underwent drainage and evacuation of the spinal abscess, followed by intravenous antibiotic administration. These interventions ameliorated the neurological deficits. The present case suggests the importance of epidural abscess as a rare pathogenetic cause of Brown-Sequard syndrome in type 2 diabetes.

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“…7 ± 10 Several explanations were o ered, such as AIDS or intravenous drug abuse 9,10 or the increasing number of elderly people. 7 ± 9 Intravenous drug abuse was thought to account for the high number of cervical abscesses as compared to series reported earlier this century.…”

Section: Discussionmentioning

confidence: 99%

“…7,9,10,17,22 Repeated postoperative ESR measurements and measurements of C reactive protein (CRP) may indicate successful treatment or alert the physician to a new or not su ciently treated infectious problem.…”

Section: Systemic Parameters Of Infectionmentioning

confidence: 99%

Extradural infections of the spine

Klekamp

Samii

1999

Spinal Cord

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Objectives:We have observed a recent increase in the incidence of spinal extradural infections. To determine postoperative outcome and prognosis we have undertaken a retrospective study on patients with spinal extradural abscesses between 1978 and 1996 treated in the Department of Neurosurgery at the Nordstadt Hospital in Hannover, Germany. Methods: Case records, outpatient ®les, operation notes, neuroradiological examinations and pathological reports were analysed. Neurological function was documented using a score system for each symptom. Results: Twenty-two patients underwent 24 operations during the study period. Staphylococcus aureus was the organism most commonly isolated. Patients presented after a mean history of 1.8+2.6 months with acute development of severe para-or tetraparesis and were followed up for an average period of 6+7 months. Two groups were distinguished. One group was characterized by epidural collections of pus (14 patients). Two patients in this group were not operated due to their moribund state and died from uncontrollable septicemia. Two of the remaining 12 operated patients died within 30 days after surgery due to generalized septicemia or other medical problems unrelated to the spinal involvement. Of the ten surviving patients, ®ve sustained major neurological de®cits, whereas the remaining ®ve patients made an incomplete recovery. The second group consisted of eight patients in a signi®cantly better pre-operative health condition in whom granulomatous material was obtained during the operation and the outcome was considerably better. No patient in this group died. Six patients recovered with no or mild neurological de®cits. Conclusion: Spinal extradural infections require immediate surgical intervention. Neurological outcome depends on the pre-operative neurological status. Survival is determined by the general health condition of the patient.

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Spinal epidural abscess: A report of 40 cases and review

Cited by 266 publications

References 26 publications

Infectious disease of the spine: outcome of rehabilitation

Infectious disease of the spine: outcome of rehabilitation

Cervical Epidural Abscess Presenting with Brown-Sequard Syndrome in a Patient with Type 2 Diabetes

Extradural infections of the spine

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