Epidural abscess in the cervical spine.

D. Rigamonti, L. Liem, A. L. Wolf, M. S. Fiandaca, Y. Numaguchi, F. P. Hsu, E. S. Nussbaum

Research output: Contribution to journalArticle

Abstract

A ten-year retrospective review of 23 cases of documented spinal epidural abscess in the cervical spine was undertaken to define the clinical features and establish current diagnostic and therapeutic criteria. Diagnosis was made by magnetic resonance imaging or myelography. Risk factors included intravenous drug abuse, diabetes mellitus, previous trauma, and a positive serologic test for the human immunodeficiency virus. A bacterial agent was isolated in 21 cases (91%). Neurologic deficits were present in 20 of the cases (87%) at the time of diagnosis. Erythrocyte sedimentation rate was elevated in all patients in whom it was measured. All patients were treated with appropriate antibiotics, usually for 6 to 8 weeks. Twenty-one patients underwent operative procedures using percutaneous aspiration (1 patient), the anterior approach (14 patients) or the posterior approach (4 patients), or a combination of the two approaches (2 patients). Four of ten patients who initially had less than antigravity strength were eventually ambulatory and continent; in each case, operative decompression was performed within 36 hours of initial consultation. Three patients who had no initial neurologic deficits remained intact.

Original languageEnglish (US)
Pages (from-to)357-362
Number of pages6
JournalThe Mount Sinai journal of medicine, New York
Volume61
Issue number4
StatePublished - Sep 1994

ASJC Scopus subject areas

  • Medicine(all)

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    Rigamonti, D., Liem, L., Wolf, A. L., Fiandaca, M. S., Numaguchi, Y., Hsu, F. P., & Nussbaum, E. S. (1994). Epidural abscess in the cervical spine. The Mount Sinai journal of medicine, New York, 61(4), 357-362.