Primary pyogenic spinal epidural abscess: How late is too late and how bad is too bad? – A study on surgical outcome after delayed presentation

Avanali, Raghunath; Ranjan, Manish; Ramachandran, Sudheesh; Devi, Bhagavatula Indira; Narayanan, Vinayak

doi:10.3109/02688697.2015.1063585

Cited by 6 publications

(11 citation statements)

References 24 publications

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“…Our patient had similar presentation without any neurological deficits. Neurological deficits can be seen in case of delayed diagnosis and may be due to direct thecal sac compression, ischemia of the roots or inflammation of the thecal sac and roots [5]. Early diagnosis and treatment is imperative, as delay can lead to irreversible neurological deficits.…”

Section: Discussionmentioning

confidence: 99%

“…SEA is a rare condition [3,5]. The exact incidence is not known but one study reports incidence of 0.2-2.8 per 10,000 cas es of epidural abscesses after spinal inter ventions [5].…”

Section: Discussionmentioning

confidence: 99%

“…Hence, if the patient develops infection, it may be masked, thus delaying the diagnosis. This delay can lead to catastrophic consequences including permanent weakness, sensory loss, and sphincter disturbances [5].…”

Section: Discussionmentioning

confidence: 99%

“…Primary SEA occurs due to hematogenous spread; while, secondary SEA occurs following spine surgery, local spinal injections, penetrating trauma, etc. [5].…”

Section: Discussionmentioning

confidence: 99%

“…[3]. Common complications seen following the procedure include infection, dural puncture, nerve damage and problems due to steroid use [5,6]. There are several case reports and case series on occurrence of SEA following spinal instrumentation and spinal epidural anesthesia [6].…”

Section: Discussionmentioning

confidence: 99%

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Spinal Epidural Abscess Following Administration of Epidural Steroid Injection for Low Backache – Need for Urgent Diagnosis and Intervention

Mathew¹,

Savardekar²,

Pruthi³

2017

J Spine

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Background: Epidural steroid injection is an innocuous and efficient modality of treatment for chronic low back ache due to a multitude of causes, its use being on the rise in recent times. However, a note needs to be made regarding the potentially serious complications following epidural steroid injection including epidural space infection. This condition requires a high index of suspicion for early diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

“…SEA is a rare condition [3,5]. The exact incidence is not known but one study reports incidence of 0.2-2.8 per 10,000 cas es of epidural abscesses after spinal inter ventions [5].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Primary SEA occurs due to hematogenous spread; while, secondary SEA occurs following spine surgery, local spinal injections, penetrating trauma, etc. [5].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Spinal Epidural Abscess Following Administration of Epidural Steroid Injection for Low Backache – Need for Urgent Diagnosis and Intervention

Mathew¹,

Savardekar²,

Pruthi³

2017

J Spine

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Spinal epidural abscess

Nazarenko,

Kuleshov,

Yundin

et al. 2024

N.N. Priorov Journal of Traumatology and Orthopedics

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Introduction. A spinal epidural abscess (SEA) is a rare but serious infectious disease characterized by the accumulation of pus in the spinal epidural space. This condition can lead to compression of the spinal cord and nerve roots, which, if diagnosis is delayed or mistaken, may result in persistent neurological deficits or even death. In recent decades, the incidence of SEA has been increasing, linked to an aging population, the spread of invasive medical procedures, and the rise of risk factors such as diabetes, obesity, and intravenous drug use. Diagnosing SEA is challenging due to its nonspecific symptoms; however, clinical awareness, along with early use of magnetic resonance imaging (MRI), enables timely detection and treatment. Clinical case description. A 55-year-old patient presented with complaints of weakness in all limbs and neck pain. The patient’s history began approximately four months earlier with a sore throat, followed by progressive limb weakness. MRI and CT imaging revealed an SEA at the C4-C5 level, causing spinal cord compression. The patient underwent C4 and C5 corpectomy, abscess removal and drainage, and stabilization with a cervical plate and autograft. In the postoperative period, the patient showed significant improvement; by discharge, the neurological deficit had substantially regressed. Conclusion. This review highlights the need to increase SEA awareness among healthcare professionals to facilitate early diagnosis and treatment initiation, particularly in high-risk patients. Despite advancements in treatment, mortality and neurological complications remain significant, underscoring the need for further research to optimize treatment strategies and improve outcomes for patients with SEA.

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Spinal Epidural Abscess: A Review of Presentation, Management, and Medicolegal Implications

Sharfman¹,

Gelfand²,

Shah³

et al. 2020

Asian Spine J

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Spinal epidural abscess (SEA) is a rare condition associated with significant morbidity and mortality. Despite advances in diagnostic medicine, early recognition of SEAs remains elusive. The vague presentation of the disease, coupled with its numerous risk factors, the diagnostic requirement for obtaining advanced imaging, and the necessity of specialized care constitute extraordinary challenges to both diagnosis and treatment of SEA. Once diagnosed, SEAs require urgent or emergent medical and/or surgical management. As SEAs are a relatively rare pathology, high-quality data are limited and there is no consensus on their optimal management. This paper focuses on presenting the treatment modalities that have been successful in the management of SEAs and providing a critical assessment of how specific SEA characteristics may render one infection more amenable to primary surgical or medical interventions. This paper reviews the relevant history, epidemiology, clinical presentation, radiology, microbiology, and treatment of SEAs and concludes by addressing the medicolegal implications of delayed treatment of the disease.

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Primary pyogenic spinal epidural abscess: How late is too late and how bad is too bad? – A study on surgical outcome after delayed presentation

Cited by 6 publications

References 24 publications

Spinal Epidural Abscess Following Administration of Epidural Steroid Injection for Low Backache – Need for Urgent Diagnosis and Intervention

Spinal Epidural Abscess Following Administration of Epidural Steroid Injection for Low Backache – Need for Urgent Diagnosis and Intervention

Spinal epidural abscess

Spinal Epidural Abscess: A Review of Presentation, Management, and Medicolegal Implications

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