Spinal Epidural Abscess
Author:
Publisher
Springer Science and Business Media LLC
Subject
General Medicine
Link
https://link.springer.com/content/pdf/10.1007/s40138-024-00284-9.pdf
Reference31 articles.
1. • Schwab JH, Ahah AA. Spinal epidural abscess: Diagnosis, management, and outcomes. J Am Acad Orthop Surg. 2020;28(21):e929–38. Misdiagnosis is very common due to variable presentation.; Prompt diagnosis is key because treatment delay can lead to paralysis or death.; Nonoperative management may represent an alternative in select cases.
2. Reihsaus E, Waldbaur H, Seeling W. Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev. 2000;23:175–204. https://doi.org/10.1007/PL00011954.
3. • Tetsuka S, Suzuki T, Ogawa T, Hashimoto R, Kato H. Spinal epidural abscess: A review highlighting early diagnosis and management. JMA J. 2023;3(1):29–40. https://doi.org/10.31662/jmaj.2019-0038. a. Gadolinium-enhanced MRI is the most sensitive, specific, and beneficial imaging modality for establishing a diagnosis of SEA.; b. Patients diagnosed prior to neurological deficits with a known causative microbial organism can be safely treated with antimicrobial therapy alone.; c. 30%-40% of the patients fail in conservative management without surgery.
4. Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM. Bacterial spinal epidural abscess. Review of 43 cases and literature survey. Medicine (Baltimore). 1992;71(6):369–85.
5. • Long B, Carlson J, Montrief T, Koyfman A. High risk and low prevalence diseases: spinal epidural abscess. Am J Emerg Med. 2022;53:168–72. https://doi.org/10.1016/j.ajem.2022.01.008. a. SEA is a challenging diagnosis due to its range of risk factors and variety of presentations with up to 90% of patients misdiagnosed on their first ED visit.; b. Factors associated with increased risk of SEA include immunocompromise, bacteremia, contiguous infection (e.g., psoas muscle abscess, osteomyelitis, skin infection), and spinal instrumentation.; c. The classic triad of back pain, fever, and neurologic deficit occurs in less than 8% of cases, though back pain is a common presenting symptom.; d. Up to half of patients experience a neurologic abnormality, but fever is absent in 50%.
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