Spinal Epidural Abscess: A Single-Center Retrospective Review of Incidence, Risk Factors, and Management at a Community Hospital

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.