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Epidural spinal abscesses
K Dei-Anang1, U Hase, K Schürmann
1Neurosurgical Department, Johannes Gutenberg University, Mainz, West Germany.
Abstract:
Fifteen cases of peridural empyemas are reported. 12 patients reported with motor dysfunction of the lower extremities and pain radiating from the spine. In one case, localized pain of the spine was discovered and in two cases there were no signs of spinal or radiating pain. Treatment in all cases was laminectomy and systemic antibiotic administration. Microbiological analysis showed staphylococcus aureus in 11 cases. 9 patients recovered with no neurological defects, two had major improvement of the paresis, and one died. Three patients with paraplegia recovered from the primary infection.
Insights
Peridural empyemas, often caused by Staphylococcus aureus, can lead to severe neurological deficits. Prompt surgical decompression and antibiotics offer a good prognosis for patients with spinal epidural abscesses.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Spinal Surgery
Background:
- Peridural empyemas, or spinal epidural abscesses, are serious infections.
- These infections can cause significant neurological impairment, including motor dysfunction and radiating pain.
- Prompt diagnosis and treatment are crucial for patient outcomes.
Purpose of the Study:
- To report on the clinical presentation, treatment, and outcomes of peridural empyema cases.
- To analyze the microbiological findings in patients with spinal epidural abscesses.
- To evaluate the effectiveness of laminectomy and antibiotic therapy.
Main Methods:
- Retrospective review of fifteen peridural empyema cases.
- Surgical intervention via laminectomy.
- Systemic antibiotic administration.
- Microbiological analysis for pathogen identification.
Main Results:
- Staphylococcus aureus was the most common pathogen, identified in 11 cases.
- 12 patients presented with lower extremity motor dysfunction and radiating spinal pain.
- 9 patients recovered fully, 2 showed major improvement, and 1 patient died.
- Three patients with paraplegia achieved recovery from the primary infection.
Conclusions:
- Laminectomy combined with systemic antibiotics is an effective treatment for peridural empyemas.
- Early intervention is associated with favorable neurological recovery.
- Staphylococcus aureus is a predominant causative agent, necessitating targeted antibiotic therapy.