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Spinal subdural abscess following epidural steroid injection
Matthew J Kraeutler1, Joseph D Bozzay, Matthew P Walker
1West Virginia University, Charleston Division, Charleston, West Virginia.
Journal of Neurosurgery. Spine
|October 25, 2014
Summary
A spinal subdural abscess developed in a man after an epidural steroid injection for low-back pain. Early surgical and antibiotic treatment led to a successful recovery, highlighting infection risks.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Radiology
Background:
- Spinal subdural abscess is a rare but serious complication.
- Epidural steroid injections are commonly used for low-back pain management.
- L5-S1 disc herniation can predispose individuals to spinal abnormalities.
Observation:
- A 58-year-old man developed a cervicothoracolumbosacral spinal subdural abscess.
- Symptoms arose approximately one month after an epidural steroid injection.
- Initial MRI did not reveal the subdural empyema, which became evident 5 days later.
Findings:
- The patient underwent successful surgical intervention and antibiotic therapy.
- The subdural empyema was extensive.
- The patient showed significant recovery and was doing well over 21 months post-operation.
Implications:
- Spinal epidural steroid injections carry a risk of infection.
- Pre-existing spinal conditions like disc herniation may increase the risk of spinal subdural empyema.
- Prompt recognition and intervention are crucial for managing extensive spinal subdural abscesses.
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