Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 5;12(13):4509.
doi: 10.3390/jcm12134509.

Cervical Spinal Epidural Abscess: Diagnosis, Treatment, and Outcomes: A Case Series and a Literature Review

Stamatios A Papadakis  1 , Margarita-Michaela Ampadiotaki  1 , Dimitrios Pallis  1 , Konstantinos Tsivelekas  1 , Petros Nikolakakos  1 , Labrini Agapitou  1 , George Sapkas  2
Affiliations

Cervical Spinal Epidural Abscess: Diagnosis, Treatment, and Outcomes: A Case Series and a Literature Review

Stamatios A Papadakis et al. J Clin Med. .

Abstract

Although recent diagnostic and management methods have improved the prognosis of cervical epidural abscesses, morbidity and mortality remain significant. The purpose of our study is to define the clinical presentation of cervical spinal epidural abscess, to determine the early clinical outcome of surgical treatment, and to identify the most effective diagnostic and treatment approaches. Additionally, we analyzed studies regarding cervical epidural abscesses and performed a review of the literature. In this study, four patients with spinal epidural abscess were included. There were three men and one woman with a mean age of 53 years. Three patients presented with motor deficits, and one patient was diagnosed incidentally through spinal imaging. All the patients had fever, and blood cultures were positive. Staphylococcus aureus was the most common organism cultured from abscesses. All patients underwent a surgical procedure, and three patients recovered their normal neurological functions, but one remained with mild neurological disability that was resolved two years postoperatively. The mean follow-up period was 12 months, and no deaths occurred in this series. Furthermore, we identified 85 studies in the literature review and extracted data regarding the diagnosis and management of these patients. The timely detection and effective management of this condition are essential for minimizing its associated morbidity and mortality.

Keywords: cervical spinal epidural abscess; outcome; surgery; treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Preoperative magnetic resonance imaging (MRI) sequence T2 lateral view. There is a cervical epidural abscess within the spinal canal below the posterior longitudinal ligament extending from C1 to C5, deformation of the signal of the spinal cord due to an inflammatory reaction. (b) Preoperative magnetic resonance imaging (MRI) sequence T2 axial view. The presence of a pathological cavity below the posterior longitudinal ligament is observed, causing compression of the thecal sac. (c) Preoperative magnetic resonance imaging (MRI) sequence T1 lateral view.
Figure 2
Figure 2
The patient underwent surgical intervention with decompression of the thecal sac. The first procedure was performed using an anterior approach, during which the affected vertebral bodies of C4 and C5 were removed and decompression of the thecal sac was carried out. A titanium cylinder was placed, and anterior stabilization was completed with a plate. Anteroposterior and lateral radiographs.
Figure 3
Figure 3
Postoperative magnetic resonance imaging, sagittal and axial views. The presence of a titanium mesh cage and dilation of the spinal cord sac are observed.
Figure 4
Figure 4
Literature search and flowchart.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Bluman E.M., Palumbo M.A., Lucas P.R. Spinal Epidural Abscess in Adults. J. Am. Acad. Orthop. Surg. 2004;12:155–163. doi: 10.5435/00124635-200405000-00003. - DOI - PubMed
    1. Savage K., Holtom P.D., Zalavras C.G. Spinal Epidural Abscess. Early Clinical Outcome in Patients Treated Medically. Clin. Orthop. Relat. Res. 2005;439:56–60. doi: 10.1097/01.blo.0000183089.37768.2d. - DOI - PubMed
    1. Darouiche R.O., Hamill R.J., Greenberg S.B. Bacterial spinal epidural abscess. Review of 43 cases and literature survey. Medicine. 1992;71:369–385. doi: 10.1097/00005792-199211000-00004. - DOI - PubMed
    1. Maslen D.R., Jones S.R., Crislip M.A., Bracis R., Dworkin R.J., Flemming J.E. Spinalepidural abscess: Optimizing patient care. Arch. Intern. Med. 1993;153:1713–1721. doi: 10.1001/archinte.1993.00410140107012. - DOI - PubMed
    1. Danner R.L., Hartman B.J. Update of spinal epidural abscess: 35 cases and review of the literature. Rev. Infect. Dis. 1987;9:265–274. doi: 10.1093/clinids/9.2.265. - DOI - PubMed

LinkOut - more resources