Issue release date: 12.11.2024
2American Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
3American Hospital, Department of Anesthesiology and Pain Management, Istanbul, Turkey
4American Hospital, Department of Radiology, Istanbul, Turkey DOI : 10.5137/1019-5149.JTN.3118-10.0 AIM: Spontaneous pyogenic spinal epidural abscess (SEA) is a rare condition but might be devastating and fatal. Traditional treatment is surgical decompression and antibiotics. A retrospective study was designed to assess the eff ect of clinical findings and treatment methods on the outcome.
MATERIAL and METHODS: 14 patients were reviewed (10 male, 4 female, mean age 59.14). Six dorsal, seven ventral and one dorsal with ventral SEA were observed. SEA found in thoracal (5), lumbar (4), cervical (3) regions. One patient showed both cervical and thoracal and one patient showed cervical, thoracal and lumbar involvement. All patients received minimum 3 weeks of I.V., followed by minimum 3 weeks of oral antibiotics. All patients complained of spinal pain. Ten patients presented with fever. Neurological deficit was observed in 9 cases.
RESULTS: A total of 22 interventions was performed. Instrumentation was applied in 5 cases. Full recovery was achieved in 7 patients, significant improvement was observed in 5 patients. The neurological findings did not change in one patient. One mortality and one morbidity were observed.
CONCLUSION: Spontaneous SEA is a rare disease but might result in catastrophic neurological deficits and fatal even with prompt treatment. Therefore, one should always keep SEA in mind if a patient presents with fever, vague and spinal pain.
Keywords : Spinal infection, Spinal epidural abscess, Spondylodiscitis, Spinal instrumentation, Antibiotics, Spinal surgery