Title comparison of primary and secondary spinal epidural abscesses

Khan, Shah-Naz H.; Hussain, Mohammed; Griebel, Robert; Hattingh, Suzanne

doi:10.1016/s0090-3019(02)00925-4

Cited by 58 publications

(42 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Spinal epidural abscess is first reported by Morgagni in 1796 (19,33). In 1948, Huesner described the clinical findings, treatment and outcome of SEA (15).…”

Section: Discussionmentioning

confidence: 99%

Spontaneous pyogenic spinal epidural abscess

Öktenoğlu¹,

Sasani²,

Çetin³

et al. 2010

Turkish Neurosurgery

View full text Add to dashboard Cite

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.

show abstract

“…Spinal epidural abscess is first reported by Morgagni in 1796 (19,33). In 1948, Huesner described the clinical findings, treatment and outcome of SEA (15).…”

Section: Discussionmentioning

confidence: 99%

Spontaneous pyogenic spinal epidural abscess

Öktenoğlu¹,

Sasani²,

Çetin³

et al. 2010

Turkish Neurosurgery

View full text Add to dashboard Cite

show abstract

“…46 Some have defined secondary SEA as being associated with vertebral osteomyelitis. 20 Most patients are in the 50-to 70-year age range; men are more likely to be afflicted. 23 Origins or foci of infection have been identified and include pathogens in skin, oral mucosa, genitourinary system, and bowel.…”

Section: Literature Reviewmentioning

confidence: 99%

An institutional series and contemporary review of bacterial spinal epidural abscess: current status and future directions

Shweikeh

Saeed

Bukavina

et al. 2014

FOC

View full text Add to dashboard Cite

Object Over the past decade, the incidence of bacterial spinal epidural abscess (SEA) has been increasing. In recent years, studies on this condition have been rampant in the literature. The authors present an 11-year institutional experience with SEA patients. Additionally, through an analysis of the contemporary literature, they provide an update on the challenging and controversial nature of this increasingly encountered condition. Methods An electronic medical record database was used to retrospectively analyze patients admitted with SEA from January 2001 through February 2012. Presenting symptoms, concurrent conditions, microorganisms, diagnostic modalities, treatments, and outcomes were examined. For the literature search, PubMed was used as the search engine. Studies published from January 1, 2000, through December 31, 2013, were critically reviewed. Data from articles on methodology, demographics, treatments, and outcomes were recorded. Results A total of 106 patients with bacterial SEA were identified. The mean ± SD age of patients was 63.3 ± 13.7 years, and 65.1% of patients were male. Common presenting signs and symptoms were back pain (47.1%) and focal neurological deficits (47.1%). Over 75% of SEAs were in the thoracolumbar spine, and over 50% were ventral. Approximately 34% had an infectious origin. Concurrent conditions included diabetes mellitus (35.8%), vascular conditions (31.3%), and renal insufficiency/dialysis (30.2%). The most commonly isolated organism was Staphylococcus aureus (70.7%), followed by Streptococcus spp. (6.6%). Surgery along with antibiotics was the treatment for 63 (59.4%) patients. Surgery involved spinal fusion for 19 (30.2%), discectomy for 14 (22.2%), and corpectomy for 9 (14.3%). Outcomes were reported objectively; at a mean ± SD follow-up time of 8.4 ± 26 weeks (range 0–192 weeks), outcome was good for 60.7% of patients and poor for 39.3%. The literature search yielded 40 articles, and the authors discuss the result of these studies. Conclusions Bacterial SEA is an ominous condition that calls for early recognition. Neurological status at the time of presentation is a key factor in decision making and patient outcome. In recent years, surgical treatment has been advocated for patients with neurological deficits and failed response to medical therapy. Surgery should be performed immediately and before 36–72 hours from onset of neurological sequelae. However, the decision between medical or surgical intervention entails individual patient considerations including age, concurrent conditions, and objective findings. An evidence-based algorithm for diagnosis and treatment is suggested.

show abstract

“…6 Para la adquisición del empiema epidural, existen múltiples condiciones predisponentes, tales como enfermedades de base (diabetes m e l l i t u s , i n f e c c i ó n p o r v i r u s d e l a inmunodeficiencia humana -VIH-), anomalías espinales, tatuajes, acupuntura, analgesia epidural, trauma e infecciones de la piel y las partes blandas, entre otros. 7,8 El arribo del germen al sitio de infección se logra a través de la vía hematógena o por contigüidad; la primera es la más frecuente en la población pediátrica. 9 Se supone que la puerta de entrada para l a i n f e c c i ó n d e n u e s t r a p a c i e n t e f u e r o n las lesiones ampollares de las piernas con p o s t e r i o r d i s e m i n a c i ó n h e m a t ó g e n a , a pesar de presentar hemocultivos negativos.…”

Section: Discussionunclassified

Absceso epidural espinal: caso clínico pediátrico

2017

Arch Argent Pediat

View full text Add to dashboard Cite

Presentación de casos clínicos RESUMENEl absceso epidural espinal, una patología poco frecuente, presenta una incidencia de un caso cada 100 000 individuos, y se observa un aumento debido al incremento de factores de riesgo, tales como diabetes mellitus, anomalías espinales, tatuajes, acupuntura, analgesia epidural, sumado a una mayor disponibilidad de métodos de imágenes. Es una colección purulenta localizada entre la duramadre y el canal medular. Los gérmenes más comunes son Staphylococcus aureus y bacterias Gram-negativas. Sin tratamiento oportuno, evoluciona a la compresión medular y secuelas neurológicas permanentes. Una niña de 11 años se presentó con fiebre de 48 horas de evolución, dolor lumbar izquierdo, marcha antálgica con envaramiento lumbar. El examen neurológico era normal. Sobre los miembros inferiores, se observaban lesiones ampollares destechadas. La resonancia nuclear magnética mostró una imagen compatible con absceso epidural espinal. Evolucionó favorablemente. El tratamiento consistió en drenaje quirúrgico y antibióticos por 6 semanas. Del cultivo del material obtenido, creció Staphylococcus aureus meticilino sensible. Palabras clave: absceso epidural, pediatría. ABSTRACTSpinal epidural abscess is an uncommon pathology. It has an incidence of one case per 100 000 individuals. An increase is observed due to the raise of risk factors such as diabetes mellitus, spinal abnormalities, tattoos, acupuncture, epidural analgesia, and a greater availability of imaging methods. It is a purulent collection located between the dura and the medullary canal. The most common germs are Staphylococcus aureus and Gram-negative bacteria. Without timely treatment, it evolves to medullary compression and permanent neurological sequelae. An 11-year-old girl was admitted with fever of 48 hs evolution, left lower back pain, antalgic gait with lumbar stiffness. Neurological examination was normal. Blunt blistering lesions were observed on lower limbs. Magnetic resonance imaging showed an image compatible with spinal epidural abscess. The evolution was favorable. Treatment consisted of surgical drainage and antibiotics for 6 weeks. From the culture of the material obtained, methicillin-sensitive Staphylococcus aureus was isolated.

show abstract

Title comparison of primary and secondary spinal epidural abscesses

Cited by 58 publications

References 30 publications

Spontaneous pyogenic spinal epidural abscess

Spontaneous pyogenic spinal epidural abscess

An institutional series and contemporary review of bacterial spinal epidural abscess: current status and future directions

Absceso epidural espinal: caso clínico pediátrico

Contact Info

Product

Resources

About