Table 1. Risk Factors for SEA.

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)
Table 2. Stages According to Clinical Severity in SEA.

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
Table 3. Predictive Factors for Failure of Nonoperative Management.

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
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