Spinal Epidural Abscess: Result of 39 Patients and Evaluation of Prognostic Factors

Young Ha Kim; Dong Wuk Son; Sung Hoon Kim; Sang Weon Lee; Geun Sung Song

doi:10.13004/jknts.2009.5.2.68

Journal List > J Korean Neurotraumatol Soc > v.5(2) > 1084052

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Kim, Son, Kim, Lee, and Song: Spinal Epidural Abscess: Result of 39 Patients and Evaluation of Prognostic Factors

Clinical Article

Journal of Korean Neurotraumatology Society 2009; 5(2): 68-73.

Published online: 31 December 2009

DOI: https://doi.org/10.13004/jknts.2009.5.2.68

Spinal Epidural Abscess: Result of 39 Patients and Evaluation of Prognostic Factors

Young Ha Kim, MD, Dong Wuk Son, MD, Sung Hoon Kim, MD, Sang Weon Lee, MD, Geun Sung Song, MD

Department of Neurosurgery, Pusan National University School of Medicine, Yangsan, Korea.

Address for correspondence: Dong Wuk Son, MD. Department of Neurosurgery, Pusan National University School of Medicine, Beomeo-ri, Mulgeum-eup, Yangsan 626-870, Korea. Tel: +82-55-360-2126, Fax: +82-55-360-2156, theworkholic@naver.com

Received 7 August 2009 Revised 11 August 2009 Accepted 22 September 2009

Abstract

Objective

Despite advances in neuroimaging and neurosurgical care, spinal abscess remains a challenging problem with high morbidity rate. So we conducted a retrospective study to define its clinical feature and to evaluate its prognostic factors.

Methods

The charts of 39 patients with spinal epidural abscess over a 6-year period (from January 2001 to December 2006) were reviewed and analyzed.

Results

The 39 spinal epidural abscess included 22 men and 17 women with a mean age of 58 years. Localized spinal pain, paralysis, fever/chilling were the common manifestations. The most common pathogens were Mycobacterium tuberculosis, but we could not found pathogen in 19 cases. Decreased initial level of consciousness (drowsy-stupor) may predicted a poor prognosis, but no statistic significance.

Conclusion

Localized back pain in a febrile patient with significant risk of epidural abscess warrants an immediate evaluation. Good neurological recovery can be obtained despite severe neurologic deficit when treated by early diagnosis and prompt surgical intervention.

Keywords: Spinal epidural abscess, Surgery, Outcome

Figures and Tables

FIGURE 1

Comparison of age distribution between poor and good group.

FIGURE 2

Comparison of gender between poor and good group.

TABLE 1

Outcomes assessment

TABLE 2

Predisposing factors

TABLE 3

Causative organisms

MRSA: Methicillin-resistant Staphylococcus aureus, MSSA: Methicillin-sensitive Staphylococcus aureus

TABLE 4

Clinical manifestation

TABLE 5

Predictor of outcomes (1)

LOC: level of consciousness

TABLE 6

Predictor of outcomes (2)

WBC: white blood cell, Hb: hemoglobin, PLT: platelet, ESR: erythrocyte sedimentation rate, CRP: C-reactive protein

TABLE 7

Predictor of outcomes (3)

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