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Epidural Abscess

Jeremy S. Smith, M.D., Orthopaedic Spine Surgeon, Orange CA / Patient Info / Spine / Spine Conditions / General / Epidural Abscess
Epidural Abscess

What is Epidural Abscess?

An epidural abscess is a medical condition that can be defined as an infection in the region between the spine, or bones of the skull, and the membranes that surround the spinal cord (meninges) and brain.

If the infection is located inside the skull region, it is called an intracranial epidural abscess. If the infection is in the spine region, it is called a spinal epidural abscess. However, the spine region is known to be more susceptible to epidural abscesses.

The infection is usually caused by bacteria but may be caused by fungus too. The abscess may also be caused by other infections in the body such as a urinary tract infection, or from germs that travel through the blood.

What are the Causes of an Epidural Abscess?

Some of the common causes of an epidural abscess may include:

  • Previous back surgery or invasive procedure involving the spine
  • Infections of the bloodstream
  • Boils, particularly on the back or scalp
  • Vertebral osteomyelitis (bone infection of the spine)
  • Intravenous drug use
  • Chronic sinusitis
  • Chronic infections of the ear
  • Mastoiditis
  • Recent neurosurgery
  • Head injury

Signs and Symptoms of an Epidural Abscess

Signs and symptoms of an epidural abscess are dependent upon the area of the abscess and may include:

  • Fever
  • Headache
  • Disrupted consciousness
  • Difficulty with coordination and movement
  • Abnormal sensations throughout the body
  • Difficulty in walking
  • Worsening muscle weakness in both the legs and arms
  • Back pain
  • Inability to control the bladder or bowels
  • Fatigue
  • Feeling nauseous or vomiting sensation

What if an Epidural Abscess is Left Untreated?

If left untreated, serious complications can occur, including:

  • Infection inside the bones of the skull or spine
  • Meningitis (infection of the meninges)
  • Spinal cord abscess
  • Long-term back pain
  • Irreversible damage to the nervous system or brain, including paralysis

Untreated epidural abscesses can be very dangerous and in a worst-case scenario may even result in death.

Diagnosis of an Epidural Abscess

The doctor may start the diagnosis by asking questions about your medical history and symptoms. This can be followed by:

  • Magnetic resonance imaging (MRI) scan
  • Computed tomography (CT) scan
  • Tests of a fluid sample from the abscessed area to identify the cause of the infection
  • Blood tests to look for signs of infection

Treatment of an Epidural Abscess

Typically, spinal epidural abscesses are treated with antibiotics. The goal is to fight the infection that caused the abscess. If there is difficulty with movement or problems of sensation such as numbness even after antibiotic treatment, the doctor may opt for surgery. 

Surgery is likely to involve draining the fluid from the abscess with a needle or complete removal of the abscess in a worst-case scenario. 

Preventing an Epidural Abscess

Epidural abscesses can be controlled to a great extent with early and fast treatment for any infections such as sinus infections, ear infections and blood infections to help reduce the probability of developing an epidural abscess. 

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