Spinal Epidural Abscess: A Single-Center Retrospective Review of Incidence, Risk Factors, and Management at a Community Hospital
Tyler E Rice-Canetto1,2, Louis Reier3,1, Mohammad Arshad3,1
1Neurosurgery, Arrowhead Regional Medical Center, Colton, USA.
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Summary
Spinal epidural abscess (SEA) often presents with vague symptoms, delaying diagnosis. This study highlights key risk factors and common presentations to improve early detection and treatment of SEA.
Area of Science:
- Neurosurgery
- Infectious Disease
- Epidemiology
Background:
- Spinal epidural abscess (SEA) is a rare but serious condition that can lead to severe neurological deficits if not diagnosed and treated promptly.
- The classic triad of back pain, fever, and neurologic deficits is infrequently observed in SEA patients, leading to diagnostic challenges.
- Nonspecific symptoms and unremarkable inflammatory markers contribute to delayed diagnosis and management of SEA.
Purpose of the Study:
- To characterize the incidence, risk factors, and management of spinal epidural abscess (SEA) at a California community hospital.
- To optimize the timely identification and treatment of patients with SEA.
- To compare institutional findings with existing literature to improve diagnostic and therapeutic strategies.
Main Methods:
- A single-center retrospective review of 88 patients diagnosed with SEA between July 2016 and April 2021.
- Data extraction included demographics, risk factors, comorbidities, clinical presentation, diagnostics, management, and discharge disposition.
- Frequency tables and exploratory data analysis with visualizations were used to present findings; Q-Q plots and statistical tests assessed suitability for parametric testing.
Main Results:
- The study population had a male predominance with a mean age of 57 years.
- Prevalent risk factors included recent infection, smoking, alcohol use, and diabetes mellitus.
- Only 6% of patients presented with the classic triad; lumbar spine was the most common abscess location; 81% had bacteremia, and 77% of biopsy cultures were positive.
Conclusions:
- Characterizing the local SEA patient population aids in timely diagnosis and management, potentially reducing diagnostic delays.
- This data contributes to the broader literature, supporting improved diagnostic and therapeutic strategies for SEA.
- The findings are valuable for optimizing SEA management within neurosurgical departments and other institutions.