Spinal Epidural Abscess: Symptoms, Treatment

Overview

A spinal epidural abscess is an infection that occurs in the spinal cord. An abscess is a collection of pus that masses within the tissue of the body. In the pus, it usually contains dead cells, immune cells, and bacteria. In most conditions, spinal epidural abscess arises due to infected injured tissues.

Overall, a spinal epidural abscess is a rare condition. But if left untreated, the situation may become very serious. Early diagnosis plays a significant role in the later treatment. In often cases, the infection can be treated with antibiotics. But according to different situations, the doctor may take different approaches as well. Under the condition that neurological symptoms appear, additional treatment may be required.

As an uncommon condition, spinal epidural
abscess only affects 0.2 to 2 people in
10,000 people according to hospital admission data. Usually, people are at
higher risk of developing spinal epidural abscess when they are at their 60s to
70s.

Symptoms

In the beginning, a spinal epidural abscess may be asymptomatic. But
as the infection or abscess progresses, the pressure
will occur on the spinal cord, which may cause the following signs and
symptoms:

  • Sudden onset of
    pain
  • Sharp pain that
    can radiate to your arms or legs
  • Weakness that progresses
    rapidly
  • Loss of sensation
    below the area of the abscess
  • Paralysis below
    the area of the abscess
  • Loss of control of
    your bladder and bowels
  • Fever
  • Mental status
    changes

Since every individual may have different
symptoms, if you are suspicious, you’d better go to the hospital and get a
detailed diagnosis.

Causes and Risk Factors

Usually, spinal epidural abscess arises
because of bacteria, mostly Staphylococcus
aureus, and Escherichia coli. Sometimes,
the condition may occur due to fungal infection too.

Apart from the bacteria, there are also
other factors that may increase the risk of a person getting a spinal epidural abscess, such as:

  • Immunodeficiency
  • Chemotherapy
  • Immunosuppressive
    medications
  • Spinal trauma
  • Boils on the skin,
    especially the skin of the back and scalp
  • Septicemia
  • Complications from
    back surgery or a lumbar puncture procedure
  • Dermal sinus
  • Tuberculosis
  • A ruptured
    gallbladder
  • Long-term use of
    illicit drugs

Diagnosis

Given that the symptoms of a spinal epidural abscess are very similar to
other conditions, a detailed diagnosis would require multiple tests. They may
include:

  • Blood tests. With
    a sample of your blood, the doctor can check if there’s any infection. If there
    is an infection, the number of your white blood cells will be elevated because
    they are in charge of attacking and destroying the organisms that cause
    infection.
  • Cerebrospinal
    fluid testing. The doctor will perform a lumbar puncture to collect a sample of
    your cerebrospinal fluid. This testing is also for detecting infection.
  • Other imaging tests.
    The doctor may order magnetic resonance imaging (MRI), Computed tomography (CT)
    and X-rays scans to better visualize the situation.

Treatment

Early diagnosis is vital to people’s health because if spinal epidural abscess bursts, the bacteria within the abscess will spread throughout the body. Once the spinal epidural abscess is diagnosed, people with the condition should be treated right away.

Normally, the doctor will first locate the
spinal epidural abscess and then drain or
remove the abscess. To do this, the doctor may choose to perform a laminectomy.
Besides, the doctor may also prescribe some antibiotics for people with a spinal epidural abscess. Antibiotics can be
helpful to kill the bacteria and prevent further infection. What’s more, in
some cases, surgery will also be done with the aim of decompressing the spinal
cord. The lamina is often removed in the surgical procedure so that there’s
enough room for the spinal cord to function normally.

Keywords: spinal epidural abscess.

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