Spinal Epidural Abscess: Symptoms, Treatment

Overview

A spinal epidural abscess is an infection that occurs in the spinal cord. An abscess is a collection of pus that masses within the tissue of the body. In the pus, it usually contains dead cells, immune cells, and bacteria. In most conditions, spinal epidural abscess arises due to infected injured tissues.

Overall, a spinal epidural abscess is a rare condition. But if left untreated, the situation may become very serious. Early diagnosis plays a significant role in the later treatment. In often cases, the infection can be treated with antibiotics. But according to different situations, the doctor may take different approaches as well. Under the condition that neurological symptoms appear, additional treatment may be required.

As an uncommon condition, spinal epidural abscess only affects 0.2 to 2 people in 10,000 people according to hospital admission data. Usually, people are at higher risk of developing spinal epidural abscess when they are at their 60s to 70s.


Symptoms

In the beginning, a spinal epidural abscess may be asymptomatic. But as the infection or abscess progresses, the pressure will occur on the spinal cord, which may cause the following signs and symptoms:

  • Sudden onset of pain
  • Sharp pain that can radiate to your arms or legs
  • Weakness that progresses rapidly
  • Loss of sensation below the area of the abscess
  • Paralysis below the area of the abscess
  • Loss of control of your bladder and bowels
  • Fever
  • Mental status changes

Since every individual may have different symptoms, if you are suspicious, you’d better go to the hospital and get a detailed diagnosis.


Causes and Risk Factors

Usually, spinal epidural abscess arises because of bacteria, mostly Staphylococcus aureus, and Escherichia coli. Sometimes, the condition may occur due to fungal infection too.

Apart from the bacteria, there are also other factors that may increase the risk of a person getting a spinal epidural abscess, such as:

  • Immunodeficiency
  • Chemotherapy
  • Immunosuppressive medications
  • Spinal trauma
  • Boils on the skin, especially the skin of the back and scalp
  • Septicemia
  • Complications from back surgery or a lumbar puncture procedure
  • Dermal sinus
  • Tuberculosis
  • A ruptured gallbladder
  • Long-term use of illicit drugs

Diagnosis

Given that the symptoms of a spinal epidural abscess are very similar to other conditions, a detailed diagnosis would require multiple tests. They may include:

  • Blood tests. With a sample of your blood, the doctor can check if there’s any infection. If there is an infection, the number of your white blood cells will be elevated because they are in charge of attacking and destroying the organisms that cause infection.
  • Cerebrospinal fluid testing. The doctor will perform a lumbar puncture to collect a sample of your cerebrospinal fluid. This testing is also for detecting infection.
  • Other imaging tests. The doctor may order magnetic resonance imaging (MRI), Computed tomography (CT) and X-rays scans to better visualize the situation.

Treatment

Early diagnosis is vital to people’s health because if spinal epidural abscess bursts, the bacteria within the abscess will spread throughout the body. Once the spinal epidural abscess is diagnosed, people with the condition should be treated right away.

Normally, the doctor will first locate the spinal epidural abscess and then drain or remove the abscess. To do this, the doctor may choose to perform a laminectomy. Besides, the doctor may also prescribe some antibiotics for people with a spinal epidural abscess. Antibiotics can be helpful to kill the bacteria and prevent further infection. What’s more, in some cases, surgery will also be done with the aim of decompressing the spinal cord. The lamina is often removed in the surgical procedure so that there’s enough room for the spinal cord to function normally.


Keywords: spinal epidural abscess.


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* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.