Medical vs Surgical Management of Spinal Epidural Abscess
| Autor: | Farhan Siddiq, Abe E. Sahmoun, Raymond A. Smego, Robert Tight, Ashish Chowfin |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
Staphylococcus aureus medicine.medical_specialty Percutaneous Epidural abscess medicine.drug_class medicine.medical_treatment Antibiotics Suction Immunocompromised Host Lumbar Internal Medicine Humans Medicine Infusions Parenteral Abscess Retrospective Studies Chemotherapy business.industry Lumbosacral Region Retrospective cohort study Middle Aged medicine.disease Anti-Bacterial Agents Surgery Treatment Outcome Pulmonary aspiration Epidural Abscess Anesthesia Female Tomography X-Ray Computed business |
| Zdroj: | Archives of Internal Medicine. 164:2409 |
| ISSN: | 0003-9926 |
| DOI: | 10.1001/archinte.164.22.2409 |
| Popis: | Background We compared the clinical features and outcomes of patients with spinal epidural abscess treated with prolonged parenteral antibiotics alone or combined with computed tomography–guided percutaneous needle aspiration drainage with those of patients undergoing surgical decompression. Methods A retrospective analysis of 57 cases of spinal epidural abscess treated at an academic teaching hospital during a 14-year period. Results The lumbar region was most frequently involved, and 46% of patients were immunocompromised. Staphylococcus aureus was the most frequently encountered pathogen. For 60 treatment courses, management included medical only (25 patients), medical plus computed tomography–guided percutaneous needle aspiration (7 patients), or surgical drainage approaches (28 patients). Prolonged use of parenteral antibiotics alone or combined with percutaneous needle drainage yielded clinical outcomes at least comparable with antibiotics plus surgical intervention, irrespective of patient age, presence of comorbid illness, disease onset, neurologic abnormality at time of presentation, or abscess size. Conclusion Patients with spinal epidural abscess can be safely and effectively treated with conservative medical treatment without the need for surgery. |
| Databáze: | OpenAIRE |
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