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Rabih O. Darouiche reviews the pathogenesis of bacterial spinal epidural abscess, its clinical features, diagnosis, treatment, common diagnostic and therapeutic hazards, and outcomes.
Spinal epidural abscess generally presents as a hematogenous spread of bacterial infection (most commonly, Staphylococcus aureus). Clinical signs and symptoms are caused either directly by compression or indirectly by ischemia due to thrombophlebitis. Symptoms progress from back pain to nerve root pain to neurologic compromise to paralysis. The most vital diagnostic modality is MRI with intravenous gadolinium. White blood cell counts, tests for inflammatory markers, blood cultures, plain radiographs, and CT scans provide diagnostic confirmation. Management gene…