322 - Evaluation and Treatment of Spinal Epidural Abscess

Abstract

Epidural abscess is a relatively rare clinical entity when considering the realm of spinal pathology; however, its incidence has been steadily increasing. Diagnosis relies on clinical suspicion, laboratory data, and advanced neuroimaging. Treatment options include medical and surgical management. There are no randomized, controlled data comparing outcomes based on treatment choice and while some of the data suggest equivalent outcomes between medical and surgical management, patients presenting without any neurological deficit tend to be preferentially managed with medical management while those presenting with a neurological deficit present for less than 48 hours tend to be managed surgically. Additionally, those patients undergoing delayed surgical intervention in the setting of failed medical therapy tend to have the worst outcomes.