Lumbar spinal abscess managed conservatively

Messer, Henry D.; Lenchner, Gregory S.; Brust, John C.M.; Resor, Stanley R.

doi:10.3171/jns.1977.46.6.0825

Cited by 52 publications

(14 citation statements)

References 13 publications

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“…21,[25][26][27][28] A disease that traditionally uniformly has been considered a surgical emergency in the last few decades, is now often treated medically, albeit cautiously, as rapid deterioration and permanent neurologic deficit can still occur.…”

Section: Discussionmentioning

confidence: 99%

CT guided aspiration of a cervical spinal epidural abscess

Rust

Kohan

Steel

et al. 2005

Journal of Clinical Neuroscience

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Section: Discussionmentioning

confidence: 99%

CT guided aspiration of a cervical spinal epidural abscess

Rust

Kohan

Steel

et al. 2005

Journal of Clinical Neuroscience

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“…If this had been present for less than 24 h, a satisfactory recovery following opera tion could be expected, whilst paraplegia last ing more than 36 h was found to be corre lated with poor results. Others [24] have noted that sensory disturbances were some what predictive of outcome, since complete loss of sensation was usually present preoperatively in those patients showing poor or no recovery. However, exceptions to these rules were encountered in the present series and in the experience of other authors [14,20], Although knowledge of this pathological entity and its diagnostic possibilities may be reasonably assumed to have increased over the last few years, only a slight improvement in results is observed in the more recent series [2, 14.…”

Section: Discussionmentioning

confidence: 99%

Spinal Epidural Abscesses

Ravicovitch¹,

Spallone²

1982

Eur Neurol

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42 cases of spinal epidural abscesses were operated on in the years 1957–1980, among approximately 8.000 spinal operations. Staphylococcus aureus was the microorganism most commonly isolated from infected material and the primary source of infection was in most cases cutaneous and/or subcutaneous lesions. Typical clinical history included back pain and fever, with progressive nerve root and spinal cord involvement. The cases were divided into three groups according to the operative findings: (a) acute abscesses; (b) chronic abscesses, and (c) mixed or subacute abscesses. These three groups differed as to duration of illness, incidence of meningeal signs, white blood cell concentration and lumbar puncture results. Plain X-rays were positive in 20% of cases. Myelography, whose indications were maximally restricted, gave in some instances inaccurate results. Treatment consisted of extensive laminectomy of all the affected spinal segments, and drainage of infected material. Local and systemic appropriate antibiotic therapy was also given. An average of 16 daily sessions of barotherapy, consisting of 1.7–2.0 atm given in 40–60 min, were administered in the last 9 cases. When compared with the patients to which barotherapy was not given, these cases showed a lower rate of permanent disability (11 vs. 21%), even if they were managed under less favorable clinical and neurological conditions. These results seem to support a favorable role of hyperbaric treatment in the management of spinal epidural abscesses. Early diagnosis and appropriate management remain essential in order to have satisfactory treatment results.

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“…In the past, decompressive laminectomy was the only therapeutic approach to SEA until the recent demonstra tion that many patients can be fully managed medically [1][2][3][4]. However, it is generally agreed that the absence of severe neurological deficits and a definite identification of a pathogenic organism are prerequisites for a nonsurgical approach [4], In this case report, two conditions were present, tuber culosis and gram-negative sepsis, which are potentially causative agents of SEA [5].…”

Section: Discussionmentioning

confidence: 99%