The management of cervical and thoracic epidural abscess in the neurologically asymptomatic patient

Abstract

v c 2 n epidural abscess is a bacterial infection of the spine that results in the accumulation of purulent fluid or infected ranulation tissue in the epidural space. Most cases occur in dults (mean age, 57 years; range, 2 to 81 years).1 Occurrence n children under age 12 years is rare.2 The male-to-female atio is approximately 1:1.1 The incidence of the disease is 0.2 to .2 per 10,000 hospital admissions per year and accounts for bout 7% of spinal infections.3 The incidence of pyogenic infecion of the epidural space appears to be increasing. Danner and artman noted an increased frequency at their hospital beween 1971 and 1982.1 This increase was disproportionate to he small increase in admissions and laminectomies perormed in the same period. A report of 75 patients from altimore, Maryland, revealed an increase in the incidence of pidural abscess over the past 10-year period.4 These obserations are likely due to an increased rate of spinal surgery nd spinal anesthesia, an increase in intravenous drug abuse, mproved imaging techniques, and a heightened awareness f the disorder.