Spinal Epidural Abscess: A Review of Presentation,Management, and Medicolegal Implications

Zachary Tuvya Sharfman, Yaroslav Gelfand, Pryiam Shah, Ari Jacob Holtzman, Joseph Roy Mendelis, Merritt Drew Kinon, Jonathan David Krystal, Allan Brook, Reza Yassari, David Claude Kramer, Zachary Tuvya Sharfman, Ari Jacob Holtzman, Joseph Roy Mendelis, Jonathan David Krystal, Yaroslav Gelfand, Merritt Drew Kinon, Allan Brook, Reza Yassari, Allan Brook, David Claude Kramer

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Spinal epidural abscess (SEA) is a rare condition associated with significant morbidity and mortality. Despite advances in diagnostic medicine, early recognition of SEAs remains elusive. The vague presentation of the disease, coupled with its numerous risk factors, the diagnostic requirement for obtaining advanced imaging, and the necessity of specialized care constitute extraordinary challenges to both diagnosis and treatment of SEA. Once diagnosed, SEAs require urgent or emergent medical and/or surgical management. As SEAs are a relatively rare pathology, high-quality data are limited and there is no consensus on their optimal management. This paper focuses on presenting the treatment modalities that have been successful in the management of SEAs and providing a critical assessment of how specific SEA characteristics may render one infection more amenable to primary surgical or medical interventions. This paper reviews the relevant history, epidemiology, clinical presentation, radiology, microbiology, and treatment of SEAs and concludes by addressing the medicolegal implications of delayed treatment of the disease.

Original languageEnglish (US)
Pages (from-to)742-759
Number of pages18
JournalAsian Spine Journal
Volume14
Issue number5
DOIs
StatePublished - Oct 2020

Keywords

  • Infections
  • Spinal epidural abscess
  • Spine

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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