WITHDRAWN: Spinal epidural abscess with emphasis on early diagnosis and surgical treatment: Report of twenty-five cases and review of literature

Abstract

To improve the diagnostic identification and subsequent treatment of spinal epidural abscess (SEA) by analysing the clinical data of 25 cases. Method: We retrospectively analysed patient characteristics, disease characteristics, biomarkers, neurological function, visual analogue scale (VAS), and Oswestry Disability Index (ODI) scores of 25 patients with SEA who were admitted to the Department of Spinal Surgery, The Third Hospital of Hebei Medical University from January 2018 to June 2021. Results: Eleven out of 22 patients who received surgery showed improvement of the average muscle strength score at the time of discharge (2.00 ± 1.14 vs 4.00 ± 0.63). Muscle strength did not improve at the time of discharge for three patients who were treated with conservative antibiotic therapy. At the time of admission, patients exhibited increased white blood cell (WBC) count (7.972 ± 2.570×10 9 /L), increased neutrophil percentage (64.120 ± 14.984 %), increased procalcitonin (PCT) (0.083 ± 0.192ng/L), increased C-reactive protein (CRP) (42.181 ± 59.653 mg/L), and increased erythrocyte sedimentation rate (ESR) (40.720 ± 15.913 mm/h). During follow-up, VAS scores of all patients were improved (7.12±1.13 vs 1.48±0.96), and ODI were improved (71.80±11.94 vs 11.96±6.00) after treatment. Conclusion: For the patients with SEA, early diagnosis and surgical intervention should be considered, taking into account the patient's conditions. We recommend parenteral antibiotics treatment in parallel to one-stage posterior surgery to completely eliminate the source of infection, resulting in favourable conditions for the optimal recovery of neurological functions.