A clinical analysis of spinal epidural abscess in 47 cases

Abstract

Objective To study the clinical manifestations in patients with spinal epidural abscess(SEA). Methods The medical history, microorganism, image, treatment and prognosis of 47 cases of SEA with integrated clinical data published in CNKI were reviewed from 1979 to 2014 in China. Results Males were 32 and female were 15 in 47 cases. The age ranged from 5 to 81 years with mean of(33.8±20.3)years. The clinical manifestations included pain(95.7%, 45/47), fever(87.2%, 41/47)and weakened strength of muscle(83.0%, 39/47); the vulnerable spine involved cervix(17.0%, 8/47), thorax(66.0%, 31/47), lumbar(48.9%, 23/47)and sacrum(4.3%, 2/47). Blood culture was performed in 6 cases(12.8%), and 4 of them were positive, including three of staphylococcus aureus and one of streptococcus. Surgical treatment was given to 45 cases(95.7%)and conservative treatment to two cases(4.3%); improvement of myodynamia was noted in 30 patients(63.8%), no improvement in 11 patients(23.4%), deteriorative myodynamia in three cases(6.4%)and three of them(6.4%)without detail record. Conclusions SEA was a infectious disease liable to involved easily thoracic vertebra, then lumbar vertebra, cervical vertebra and sacrum. Staphylococcus aureus was mainly pathogenic bacteria in SEA. Spinal CT or MRI examination in the early stage of SEA can influence prognosis. Key words: Epidural abscess; Spine; Clinical analysis