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Postoperative spinal epidural empyema. Clinical and computed tomography features
R Spiegelmann1, G Findler, M Faibel
1Department of Neurosurgery, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Spine
|October 1, 1991
Summary
Postoperative spinal epidural empyema after elective spinal surgery presents with vague symptoms but is treatable. Early diagnosis via CT scans and prompt surgical evacuation with antibiotics leads to complete recovery.
Area of Science:
- Neurosurgery
- Infectious Disease
Background:
- Epidural empyema is a rare but serious complication following elective spinal surgery.
- Understanding its unique presentation and outcomes is crucial for timely diagnosis and management.
Observation:
- Four cases of postoperative spinal epidural empyema were analyzed.
- Clinical manifestations were often subtle, lacking typical signs like fever or rapid neurological decline.
- Computerized tomography (CT) was instrumental in diagnosis and monitoring disease progression.
Findings:
- Postoperative spinal epidural empyema demonstrated a generally benign clinical course, contrasting with spontaneous spinal epidural abscess.
- A variety of bacteria were identified as causative agents.
- All patients achieved a cure through surgical drainage and targeted antibiotic treatment.
Implications:
- Highlights the importance of considering spinal epidural empyema in postoperative spinal surgery patients, even with atypical symptoms.
- Emphasizes the diagnostic utility of CT scans in these challenging cases.
- Reinforces the effectiveness of combined surgical and antibiotic management for favorable outcomes.