Medical Management of Spinal Epidural Abscesses: Case Report and Review

David Wheeler, Philip Keiser, Daniele Rigamonti, Susan Keay

Research output: Contribution to journalArticle

129 Scopus citations

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 nonsurgi- cal 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
DOIs
StatePublished - Jul 1992

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ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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