From: Spinal Epidural Abscess: A Review Highlighting Early Diagnosis and Management
| Source of infection | Causative condition |
|---|---|
| Recent spinal instrumentation | Diabetes mellitus |
| Epidural anesthesia | Abnormality of the vertebral column |
| Hemodialysis (Chronic renal failure) | Trauma of the spine |
| Consecutive bones or soft tissue infection | Intravenous drug use |
| Bacteremia from distant infection (Urinary tract, Respiratory tract, Abdomen, Endocarditis, Infected vascular access, and Dental abscess) | AIDS |
| Malignancy | |
| Immunosuppressive therapy, Steroid use | |
| Alcoholism | |
| Sepsis of unknown origin | Local spinal risk factors (degenerative disc disease, large osteophytes, hypertrophied facet joints) |
| Skin (Chronic nonhealing ulcers of the extremities) |
From: Spinal Epidural Abscess: A Review Highlighting Early Diagnosis and Management
| Stage | Clinical manifestations |
|---|---|
| I | Back pain, fever, tenderness |
| II | Nerve root symptoms (radicular pain), nuchal rigidity/neck stiffness, decrease in tendon reflex |
| III | Muscle weakness, sensory abnormalities (hypesthesia, paresthesia, dysesthesia), bowel and bladder dysfunction |
| IV | Complete paralysis |
From: Spinal Epidural Abscess: A Review Highlighting Early Diagnosis and Management
| Diabetes mellitus |
| Elevated CRP (CRP level >115 mg/L (11.5 mg/dL) |
| Leukocytosis (white blood cell count >12,500 cells/L) |
| Bacteremia |
| Physician-documented decline in motor status while on intravenous antibiotics |
| Age older than 65 |
| MRSA |
| Severe neurological involvement |
| Motor deficit at presentation |
| Pathologic or compression vertebral fracture in the affected levels |
| Active malignancy |
| Sensory change |
| Dorsal location of abscess |
| Primarily radiographic evidence of disease progression |
| Progression of bony deformities in the spine |
