Spinal Epidural Abscess—Experience with 46 Patients and Evaluation of Prognostic Factors

Objective: Spinal epidural abscess is a rare infectious disorder, often with a delayed diagnosis, and associated with significant morbidity and mortality rates. We conducted a retrospective study to define its clinical characteristics and to evaluate its prognostic factors. Methods: The medical charts of 46 patients (36 men and 10 women) with spinal epidural abscess over a 10-year period (from July 1991 to May 2000) were reviewed and analyzed. Results: A high proportion of patients had underlying diseases of diabetes (46%), frequent venous puncture (35%), spinal trauma (24%), and history of spinal surgery (22%). The initial accurate diagnostic rate was 11%. Localized spinal pain (89%), paralysis (80%), fever/chills (67%), and radicular pain (57%) were the common manifestations. The erythrocyte sedimentation rate (ESR) was elevated uniformly (mean, 86.6 mm/h) when measured. Staphylococcus aureus was the most common cause of spinal epidural abscess isolated from blood (39%) and pus (50%). Low platelet counts (