[Spinal epidural abscess].

Abstract

The aspecific spinal epidural abscess is an uncommon cause of the spinal cord compression. Forty eight patients presented with epidural abscess were operated on during the last 37-year-period in the National Institute of Neurosurgery Budapest. Experiences with the diagnostic methods and the results of the treatment of these patients are analysed. Based on the case history data, preoperative symptoms and operative findings 31 male and 17 female patients (their age ranged from 15-64 years) have been selected in acute, subacute and chronic groups. Localized backpain, acceleration of the blood sedimentation, leukocytosis and fever were significant findings which were followed by sings of radicular or medullary compression. This clinical picture developed rapidly in the acute group. Aspecific abscess most commonly appeared in thoracal or lumbal localisation and was rarely found in the ventral area. Staphylococcus aureus was the causative organism in nearly 100 percent of the cases. Surgery carried out before the onset of the neurological deficits according to proper CSF examination and myelography, proved to be favourable. Early diagnosis and emergency operation led to a significant improvement of the outcome.