Medical management of spinal epidural abscesses: Case report and review

David Wheeler, Philip Keiser, Daniele Rigamonti, Susan Keay

Research output: Contribution to journalArticle

129 Citations (Scopus)

Abstract

Although the traditional management of spinal epidural abscesses includes antibiotic therapy and surgical drainage, numerous reports have appeared in the literature that describe a nonsurgical approach. We report the successful nonsurgical management of a case of an extensive spinal epidural abscess in which the patient was closely monitored by serial studies with magnetic resonance imaging. Review of the literature from 1970 to 1990 revealed 37 cases that describe conservative management of spinal epidural abscesses. Despite successful conservative management reported for some cases, sudden neurological deterioration of patients receiving appropriate antibiotic therapy has also occurred. A true index of the success of nonsurgical therapy is difficult to discern since cases may have been selectively reported and unsuccessful attempts at conservative management may have never been reported once a laminectomy was performed. A prospective investigation that includes clearly defined indications for conservative management vs. surgical intervention and that can be studied with an intention-to-treat analysis is needed.

Original languageEnglish (US)
Pages (from-to)22-27
Number of pages6
JournalClinical Infectious Diseases
Volume15
Issue number1
StatePublished - Jul 1992
Externally publishedYes

Fingerprint

Epidural Abscess
Anti-Bacterial Agents
Intention to Treat Analysis
Laminectomy
Case Management
Drainage
Therapeutics
Magnetic Resonance Imaging
Conservative Treatment

ASJC Scopus subject areas

  • Immunology

Cite this

Medical management of spinal epidural abscesses : Case report and review. / Wheeler, David; Keiser, Philip; Rigamonti, Daniele; Keay, Susan.

In: Clinical Infectious Diseases, Vol. 15, No. 1, 07.1992, p. 22-27.

Research output: Contribution to journalArticle

Wheeler, David ; Keiser, Philip ; Rigamonti, Daniele ; Keay, Susan. / Medical management of spinal epidural abscesses : Case report and review. In: Clinical Infectious Diseases. 1992 ; Vol. 15, No. 1. pp. 22-27.
@article{10780f9b261543d8bf42daa0007fd109,
title = "Medical management of spinal epidural abscesses: Case report and review",
abstract = "Although the traditional management of spinal epidural abscesses includes antibiotic therapy and surgical drainage, numerous reports have appeared in the literature that describe a nonsurgical approach. We report the successful nonsurgical management of a case of an extensive spinal epidural abscess in which the patient was closely monitored by serial studies with magnetic resonance imaging. Review of the literature from 1970 to 1990 revealed 37 cases that describe conservative management of spinal epidural abscesses. Despite successful conservative management reported for some cases, sudden neurological deterioration of patients receiving appropriate antibiotic therapy has also occurred. A true index of the success of nonsurgical therapy is difficult to discern since cases may have been selectively reported and unsuccessful attempts at conservative management may have never been reported once a laminectomy was performed. A prospective investigation that includes clearly defined indications for conservative management vs. surgical intervention and that can be studied with an intention-to-treat analysis is needed.",
author = "David Wheeler and Philip Keiser and Daniele Rigamonti and Susan Keay",
year = "1992",
month = "7",
language = "English (US)",
volume = "15",
pages = "22--27",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Medical management of spinal epidural abscesses

T2 - Case report and review

AU - Wheeler, David

AU - Keiser, Philip

AU - Rigamonti, Daniele

AU - Keay, Susan

PY - 1992/7

Y1 - 1992/7

N2 - Although the traditional management of spinal epidural abscesses includes antibiotic therapy and surgical drainage, numerous reports have appeared in the literature that describe a nonsurgical approach. We report the successful nonsurgical management of a case of an extensive spinal epidural abscess in which the patient was closely monitored by serial studies with magnetic resonance imaging. Review of the literature from 1970 to 1990 revealed 37 cases that describe conservative management of spinal epidural abscesses. Despite successful conservative management reported for some cases, sudden neurological deterioration of patients receiving appropriate antibiotic therapy has also occurred. A true index of the success of nonsurgical therapy is difficult to discern since cases may have been selectively reported and unsuccessful attempts at conservative management may have never been reported once a laminectomy was performed. A prospective investigation that includes clearly defined indications for conservative management vs. surgical intervention and that can be studied with an intention-to-treat analysis is needed.

AB - Although the traditional management of spinal epidural abscesses includes antibiotic therapy and surgical drainage, numerous reports have appeared in the literature that describe a nonsurgical approach. We report the successful nonsurgical management of a case of an extensive spinal epidural abscess in which the patient was closely monitored by serial studies with magnetic resonance imaging. Review of the literature from 1970 to 1990 revealed 37 cases that describe conservative management of spinal epidural abscesses. Despite successful conservative management reported for some cases, sudden neurological deterioration of patients receiving appropriate antibiotic therapy has also occurred. A true index of the success of nonsurgical therapy is difficult to discern since cases may have been selectively reported and unsuccessful attempts at conservative management may have never been reported once a laminectomy was performed. A prospective investigation that includes clearly defined indications for conservative management vs. surgical intervention and that can be studied with an intention-to-treat analysis is needed.

UR - http://www.scopus.com/inward/record.url?scp=0026778438&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026778438&partnerID=8YFLogxK

M3 - Article

C2 - 1617070

AN - SCOPUS:0026778438

VL - 15

SP - 22

EP - 27

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 1

ER -