14. Surgical vs. Medical Management of Spinal Epidural Abscess: A Single Center 10 Year Experience

Abstract

BACKGROUND CONTEXT: Spinal epidural abscess (SEA) is a rare condition with an overall frequency of between 0.2 to 1.2 cases per 10,000 hospital admissions. While the advent of computed tomography (CT) and magnetic resonance imaging (MRI) have improved the rapidity and accuracy of diagnosis and newer antibiotics and advances in neurosurgical techniques have provided better therapies, the outcome of SEA remains poor with only about 45% of patients achieving a full recovery. There is significant debate in the literature regarding the optimal management of patients with the diagnosis of spinal epidural abscess (SEA). While some have advocated conservative treatment with intravenous antibiotics alone in select patients, recent studies have shown that patients treated without early surgery are more likely to have poor outcomes. There is therefore a lack of definitive treatment strategy for SEA due to the conflicting data or lack thereof.