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Spinal cord abscess
Alternative namesAbscess - spinal cord
DefinitionSpinal cord abscess is a disorder characterized by inflammation and a collection of infected material (pus) around the spinal cord.
Causes, incidence, and risk factors
A spinal cord abscess is caused when infection occurs within the internal areas of the spine. An abscess of the spinal cord itself is very, very rare. A spinal abscess usually occurs as an epidural abscess .
Pus forms as a collection of fluid, destroyed tissue cells, white blood cells, and live and dead microorganisms. The pus commonly becomes encapsulated (enclosed) by a lining or membrane that forms around the edges. The pus collection ( abscess ) causes pressure on the spinal cord. The infection may cause inflammation and swelling , which also compresses the spinal cord.
Signs and testsAn examination often shows localized tenderness over the spine. A neurologic examination may indicate spinal cord compression , with involvement of the lower body (paraplegia) or the entire trunk, arms, and legs (quadriplegia). The extent of neurologic losses corresponds with the location of the lesion on the spine and with the amount of spinal cord compression.
TreatmentThe goals of treatment are to relieve spinal cord compression and cure the infection.
Urgent surgical decompression (by laminectomy, cutting through the bones of the spine) is sometimes recommended, depending on the condition of the patient. This procedure involves draining of the abscess. It occasionally is not possible to completely drain the abscess.
Antimicrobial medications are prescribed. Broad-spectrum antimicrobials or a combination of antibiotics are the most commonly used antimicrobials. Antimicrobial medications may be adjusted after a culture of pus determines the specific microorganism causing the infection.
Corticosteroids may occasionally be prescribed to reduce swelling and compression of the spinal cord.
Expectations (prognosis)An untreated spinal cord abscess progresses to spinal cord compression that causes permanent, severe paralysis and other neurologic losses. It may be life-threatening.
The outcome for a treated spinal cord abscess may vary. There may be a complete recovery. A recurrence of an abscess is possible. Incomplete drainage may result in a recurrence of an abscess or development of a chronic fibrotic (scarred) mass (aggregation of cells) in the spinal cord.
Calling your health care providerGo to the emergency room or call the local emergency number (such as 911) if symptoms of spinal cord abscess occur. This is usually an emergency condition!
PreventionThorough treatment of such as boils, tuberculosis, and others, decreases the risk.
People with endocarditis or congenital heart disorders may be advised to receive prophylactic (preventive) treatment with antibiotics prior to dental or oral (by mouth) procedures.
Update Date: 11/18/2003D. Scott Smith, MD, MSc, DTM&H, Infectious Diseases Division and Dept. of Microbiology and Immunology, Stanford University Medical School, Stanford, CA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT