Successful Nonoperative Treatment of Tuberculous Spinal Epidural Abscess with Cord Compression: The Role of Magnetic Resonance Imaging

1993 ◽  
Vol 33 (2) ◽  
pp. 177-180 ◽  
Author(s):  
N. Latronico ◽  
A. Tansini ◽  
G.F. Gualandi ◽  
M. Bonetti ◽  
A. Scalzini ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Epidural Abscess ◽  
Cord Compression ◽  
Nonoperative Treatment ◽  
Spinal Epidural Abscess ◽  
Resonance Imaging ◽  
Spinal Epidural

Changing Concepts in Spinal Epidural Abscess: A Report of 29 Cases

Neurosurgery ◽  
1990 ◽  
Vol 27 (2) ◽  
pp. 185-192 ◽  
Author(s):  
O. Del Curling ◽  
David J. Gower ◽  
Joe M. McWhorter
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Epidural Abscess ◽  
Infectious Agent ◽  
Spinal Epidural Abscess ◽  
Recent Experience ◽  
Resonance Imaging ◽  
Gram Negative ◽  
Operative Findings ◽  
Spinal Epidural

Abstract A review of our recent experience with spinal epidural abscess (SEA) reveals several important changing concepts in diagnosis, etiology, management, and outcome. All cases of SEA seen by our service from August 1975 to July 1989 were reviewed retrospectively, and 29 patients were identified (19 men and 10 women, aged 13-78 years). Abscesses were located in the lumbar (n = 21), thoracic (n = 7), and cervical (n = 1) epidural spaces. Gram-positive organisms were the infectious agent in 72% of the cases, and Staphyloccus aureus was the sole agent in 45% other agents were Gram-negative aerobes (n = 5), a Gram-negative anaerobe (n = 1), Mycobacterium tuberculosis(n = 1), and Sporotrichum schenckii(n = 1), the last occurring in a young woman with acquired immune deficiency syndrome. Seventeen patients had concomitant extraspinal infections. Diagnosis was confirmed by myelography, computed tomography, or magnetic resonance imaging. All patients underwent operative decompression and debridement; 2 required a second procedure for persistent infection. The most common operative findings were pus and granulation tissue in the epidural space (52%); the preoperative course correlated poorly with operative findings. The wound was closed primarily in 84% of cases. Postoperative intravenous antibiotic courses for the bacterial abscesses ranged from 1.5 to 6 weeks (median, 2 weeks), followed by antibiotics given orally for 0 to 6 weeks. Two patients died perioperatively. Neurological outcome was good in 21 patients and fair in 6 (mean follow-up, 1.4 years). Over the last 50 years the spectrum of organisms causing SEA has broadened, and the distinction between acute and chronic SEAs has minimal clinical significance. In addition, magnetic resonance imaging has come to have an adjunctive diagnostic role. Treatment by operative debridement, primary wound closure, and short courses of antibiotics given intravenously and orally has a consistently good result, and prognosis has markedly improved.

Magnetic Resonance Imaging in the Diagnosis of Spinal Epidural Abscess

1988 ◽  
Vol 20 (3) ◽  
pp. 323-327 ◽  
Author(s):  
Mats Erntell ◽  
Stig Holtås ◽  
Karin Norlin ◽  
Erik Dahlquist ◽  
Ingrid Nilsson-Ehle
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Resonance Imaging ◽  
Spinal Epidural

Spinal epidural abscess complicating chronic epidural analgesia in 11 cancer patients: clinical findings and magnetic resonance imaging

1999 ◽  
Vol 246 (9) ◽  
pp. 815-820 ◽  
Author(s):  
Peter Sillevis Smitt ◽  
Anna Tsafka ◽  
Martin van den Bent ◽  
Hein de Bruin ◽  
Willem Hendriks ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Epidural Analgesia ◽  
Cancer Patients ◽  
Epidural Abscess ◽  
Clinical Findings ◽  
Spinal Epidural Abscess ◽  
Resonance Imaging ◽  
Spinal Epidural

Spinal Epidural Abscess: A Ten-Year Perspective

Neurosurgery ◽  
1990 ◽  
Vol 27 (2) ◽  
pp. 177-184 ◽  
Author(s):  
Mary Louise Hlavin ◽  
Henry J. Kaminski ◽  
Jeffery S. Ross ◽  
Edward Ganz
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Epidural Abscess ◽  
Surgical Intervention ◽  
Imaging Modality ◽  
Spinal Epidural Abscess ◽  
Resonance Imaging ◽  
Laboratory Findings ◽  
Prognostic Features ◽  
Spinal Epidural

Abstract A retrospective study of spinal epidural abscess spanning 10 years and encompassing 40 patients was done. Epidemiology, clinical features, laboratory findings, radiographic imaging, therapy, and outcome were examined and compared with previous series. An increasing incidence of the disease (up to 1.96 patients per 10,000 admissions per year) and an older, more debilitated population (67% having factors predisposing them to infection) were discovered. Over half of the population was studied with magnetic resonance imaging, which was found to be equally as sensitive (91%) as myelography with computed tomography (92%). Magnetic resonance imaging offers the advantages of being noninvasive and able to delineate other entities, which makes it the imaging modality of choice. Preoperative paralysis and neurological deterioration from normal were identified as poor prognostic features. Of 7 patients with preoperative paralysis, 5 died, and the rest failed to recover neurological function. Eleven patients with initially normal neurological exams deteriorated in the hospital before surgical intervention. Eight of these patients were being treated with appropriate antibiotics; 2 became paralyzed despite more than 3 weeks of antibiotic therapy. Only 3 of these 11 patients recovered fully. Immediate surgical decompression combined with antibiotics remains the treatment of choice.

scholarly journals Spinal epidural abscess: appearance on magnetic resonance imaging as a guide to surgical management

2004 ◽  
Vol 17 (6) ◽  
pp. 1-6 ◽  
Author(s):  
Jonathon F. Parkinson ◽  
Lali H. S. Sekhon
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Epidural Abscess ◽  
Surgical Approaches ◽  
Spinal Instability ◽  
Spinal Epidural Abscess ◽  
Resonance Imaging ◽  
Decompressive Laminectomy ◽  
Spinal Epidural ◽  
Invasive Techniques

Spinal epidural abscess is associated with considerable rates of morbidity and mortality despite its infrequent occurrence. Advances in magnetic resonance (MR) imaging technology have allowed easier diagnosis of this potentially devastating condition. It is also possible to predict the intraoperative appearance of each case of spinal epidural abscess prior to the procedure, based on the MR findings. Surgical treatment of this condition usually involves extensive decompressive laminectomy, which predisposes patients to spinal instability and deformity. Recent advances in surgical approaches to spinal epidural abscess have included the institution of less invasive techniques to manage this condition, including saline washes of the epidural space through catheters introduced via limited laminotomy. The cases reported here illustrate the ability to predict the intraoperative findings in patients with spinal epidural abscess, and to adjust the surgical approach accordingly to minimize the extent of potentially destabilizing procedures without impinging on the effectiveness of treatment.

scholarly journals Role of magnetic resonance imaging in spinal trauma

2021 ◽  
Vol 9 (3) ◽  
pp. 842
Author(s):  
Ajit Ahuja ◽  
Nitin Wadnere ◽  
Simran Behl
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Cord Compression ◽  
Spinal Trauma ◽  
Resonance Imaging ◽  
Excellent Outcome ◽  
Significant Difference ◽  
Cord Injury

Background: Magnetic resonance imaging (MRI) is the modality of choice for evaluation of ligamentous and other spinal cord, soft tissue structures, disc, and occult osseous injuries. Objective evaluate the role of MRI as a non-invasive diagnostic tool in patient with spinal trauma.Methods: This study was conducted in department of radiodiagnosis, Sri Aurobindo institute of medical sciences and PG institute, Indore and approval from the ethical and research committee. The duration of this study was April 2018 to May 2020. We included 60 patients of spinal trauma referred for MRI in this study.Results: In 32 (53.3%) patients the mode of injury was road traffic accidents, in 23 (38.3%) patients it was fall and in 5 (8.3%) patients the mode of injury was any other mode. There was significant difference seen between the MR cord hemorrhage, cord compression, and code transaction.Conclusions: MRI is an excellent modality for imaging of acute spinal trauma. Normal cord on baseline MRI predicts excellent outcome. When comparing patients with complete, incomplete spinal cord injury (SCI) and spine trauma without SCI, significant difference was seen in cord hemorrhage, cord transection, cord compression.

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