How Best to Manage the Spinal Epidural Abscess? A Current Systematic Review

2016 ◽  
Vol 93 ◽  
pp. 20-28 ◽  
Author(s):  
Suganth Suppiah ◽  
Ying Meng ◽  
Michael G. Fehlings ◽  
Eric M. Massicotte ◽  
Albert Yee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Current Systematic Review ◽  
Spinal Epidural ◽  
A Current

scholarly journals Etiology and Surgical Management of Cervical Spinal Epidural Abscess (SEA):: A Systematic Review

2018 ◽  
Vol 8 (4_suppl) ◽  
pp. 59S-67S ◽  
Author(s):  
Geoffrey Stricsek ◽  
Justin Iorio ◽  
Yusef Mosley ◽  
Srinivas Prasad ◽  
Joshua Heller ◽  
...  
Keyword(s):  
Systematic Review ◽  
Epidural Abscess ◽  
Management Strategies ◽  
Spinal Epidural Abscess ◽  
Systematic Analysis ◽  
The Past ◽  
Search Terms ◽  
Meta Analyses ◽  
Spinal Epidural ◽  
Early Surgical Intervention

Study Design: Systematic analysis and review. Objective: Evaluation of the presentation, etiology, management strategies (including both surgical and nonsurgical options), and neurological functional outcomes in patients with cervical spinal epidural abscess (SEA). Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were used to create a framework based on which articles pertaining to cervical SEA were chosen for review following a search of the Ovid and PubMed databases using the search terms “epidural abscess” and “cervical.” Included studies needed to have at least 4 patients aged 18 years or older, and to have been published within the past 20 years. Results: Database searches yielded 521 potential articles in PubMed and 974 potential articles in Ovid. After review, 11 studies were ultimately identified for inclusion in this systematic review. Surgery appears to be a well-tolerated management strategy with limited complications for patients with cervical SEA. However, the quantity of data comparing medical and surgical treatment of cervical SEA is limited and the bulk of the data is derived from low quality studies. Conclusion: Data reporting was heterogeneous among studies making it difficult to draw discrete conclusions. Early surgical intervention may be appropriate in selected patients with cervical epidural abscess, but it is not clear what distinguishes these patients from those who are successfully managed nonoperatively.

scholarly journals Catheter induced spinal epidural abscess in dialysis patients: A Systematic review of descriptive studies

2021 ◽  
Author(s):  
Mohammed Zuber ◽  
BH Vidhyashree ◽  
Shifa Taj ◽  
Rajesh Venkatraman ◽  
BP Sathish Kumar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Epidural Abscess ◽  
Grey Literature ◽  
Renal Dialysis ◽  
Spinal Epidural Abscess ◽  
High Grade Fever ◽  
Literature Report ◽  
Mesh Terms ◽  
Pubmed Database ◽  
Spinal Epidural

ABSTRACT Purpose: Recently, there is an increased number of reports being published on catheter-induced spinal epidural abscess (SEA). This review aims to identify and critically evaluate all the descriptive studies that report the SEA due to catheterization and its presentation, diagnosis, management, and outcomes. Methodology: A literature search was performed in the PubMed database using MeSH terms “epidural abscess” AND “renal dialysis” from inception to January 2021 without any language restriction. Google Scholar, grey literature databases (GreyNet. OpenGrey, Grey literature Report, BIOSIS Previews), and the bibliographic search of included studies were carried out to find the additional studies. Descriptive studies describing the SEA induced by catheter usage were included in the review. Study selection, data extraction, and quality assessment were conducted by two independent reviewers any disagreement was resolved by discussing with the third reviewer. Results: Data of 6 studies were retrieved for this review which includes 11 patients (5 females and 6 males) aged from 26 to 79 years old. The most common patient’s presentation was back pain, high-grade fever, quadriparesis, neck pain, drowsy, and altered mental status. The most common isolated microorganism from the blood and catheter tip was Methicillin-resistant Staphylococcus aureus. The most common findings in all the patients were elevated erythrocyte sedimentation rate and leucocyte count. Conclusion: Clinicians must be aware of the possibilities of SEA initiated by catheter usage to prevent further consequences. Aggressive antibiotic therapy along with surgical intervention are the cornerstones in the management of SEA. Early diagnosis and initiation of treatment are important factors that decide the mortality and morbidity in patients with SEA. Keywords: Catheter; Dialysis; Spinal epidural abscess; Systematic review; Case report Protocol registration: International Prospective Register for Systematic Reviews (PROSPERO) ID: CRD42021233375

scholarly journals Incidence and risk factors for failed medical management of spinal epidural abscess: a systematic review and meta-analysis

2017 ◽  
Vol 26 (1) ◽  
pp. 81-89 ◽  
Author(s):  
Alexandra Stratton ◽  
Karla Gustafson ◽  
Kenneth Thomas ◽  
Matthew T. James
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Medical Management ◽  
Epidural Abscess ◽  
Meta Analysis ◽  
Original Data ◽  
Primary Objective ◽  
Spinal Epidural Abscess ◽  
Consensus Definition ◽  
Spinal Epidural

OBJECTIVE Spinal epidural abscess (SEA) is a life-threatening infection. It is uncertain whether medical versus surgical treatment is the ideal initial approach for neurologically intact patients with SEA. Recent evidence demonstrates that initial medical management is increasingly common; however, patients who ultimately require surgery after failed medical management may have a worse prognosis than those whose treatment was initially surgical. The primary objective of this study was to establish the current incidence of failed medical management for SEA. The secondary aim was to identify risk factors associated with the failure of medical management. METHODS The authors conducted a systematic review and meta-analysis by searching electronic databases (MEDLINE, Embase, CINAHL, and PubMed), recent conference proceedings, and reference lists of relevant articles. Studies that reported original data on consecutive adult patients with SEA treated medically were eligible for inclusion. RESULTS Twelve studies met the inclusion criteria, which included a total of 489 medically treated patients with SEA. Agreement on articles for study inclusion was very high between the reviewers (kappa 0.86). In a meta-analysis, the overall pooled risk of failed medical management was 29.3% (95% CI 21.4%–37.2%) and when medical to surgical crossover was used to define failure the rate was 26.3% (95% CI 13.0%–39.7%). Only 6 studies provided data for analysis by intended treatment, with a pooled estimate of 35.1% (95% CI 15.7%–54.4%) of failed medical management. Two studies reported predictors of the failure of medical management. CONCLUSIONS Although the incidence of failed medical management of SEA was relatively common in published reports, estimates were highly heterogeneous between studies, thus introducing uncertainty about the frequency of this risk. A consensus definition of failure is required to facilitate comparison of failure rates across studies.

Aggregatibacter aphrophilus spinal epidural abscess

2020 ◽  
Vol 13 (7) ◽  
pp. e235320
Author(s):  
Antoine Altdorfer ◽  
Pierre Gavage ◽  
Filip Moerman
Keyword(s):  
Risk Factors ◽  
Lower Limb ◽  
Rare Case ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Surgical Drainage ◽  
Eikenella Corrodens ◽  
Aggregatibacter Aphrophilus ◽  
Progressive Neurological Deficit ◽  
Spinal Epidural

A 76-year-old woman with a rare case of spinal epidural abscess (SEA) that had no risk factors for such type of infection, presented symptoms of back pain, progressive neurological deficit of the lower limb and loss of sphincter control. A gadolinium-enhanced MRI confirmed the diagnosis of an SEA. The patient underwent laminectomy with surgical drainage, where cultures showed the presence of Aggregatibacter aphrophilus, a bacterium of the HACEK group (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species), rarely involved in SEA. Following surgery, the patient was treated with intravenous ceftriaxone for 6 weeks, and this gave excellent results.

scholarly journals Rapidly Progressive Spontaneous Spinal Epidural Abscess

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Abdurrahman Aycan ◽  
Ozgür Yusuf Aktas ◽  
Feyza Karagoz Guzey ◽  
Azmi Tufan ◽  
Cihan Isler ◽  
...  
Keyword(s):  
Epidural Abscess ◽  
Delayed Diagnosis ◽  
Clinical Findings ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
Low Back ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Paraspinal Abscess ◽  
Spinal Epidural

Spinal epidural abscess (SEA) is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. In case of delayed diagnosis and treatment, SEA may spread to the epidural space and may cause neurological deficits. Magnetic resonance imaging (MRI) remains the method of choice in the diagnosis of SEA. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation.

Spinal epidural abscess: a meta-analysis of 915 patients

2001 ◽  
Vol 24 (2-3) ◽  
pp. 156-156 ◽  
Author(s):  
Y. Erşahin
Keyword(s):  
Epidural Abscess ◽  
Meta Analysis ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural

scholarly journals Spinal Epidural Abscess Associated With Moxibustion-Related Infection of the Finger

2008 ◽  
Vol 31 (3) ◽  
pp. 319-323 ◽  
Author(s):  
Kyung Whan Lee ◽  
Soo Jeong Han ◽  
Dong Jun Kim ◽  
Mee Jin Lee
Keyword(s):  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural

Spinal Epidural Abscess: A 5-Year Case-Controlled Review of Neurologic Outcomes After Rehabilitation

2009 ◽  
Vol 90 (3) ◽  
pp. 512-516 ◽  
Author(s):  
David W. Koo ◽  
Andrea F. Townson ◽  
Marcel F. Dvorak ◽  
Charles G. Fisher
Keyword(s):  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Neurologic Outcomes ◽  
Spinal Epidural

scholarly journals Acute spinal epidural abscess

Spinal Cord ◽  
1979 ◽  
Vol 17 (3) ◽  
pp. 330-336 ◽  
Author(s):  
R N Hakin ◽  
A A Burt ◽  
J B Cook
Keyword(s):  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural
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