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Long‐term outcome after neurosurgically treated spinal epidural abscess following epidural analgesia
Author(s) -
Wang L. P.,
Hauerberg J.,
Schmidt J. F.
Publication year - 2001
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2001.450215.x
Subject(s) - medicine , epidural abscess , paresis , surgery , abscess , anesthesia , lumbar
Background: A recent investigation demonstrated a high incidence of epidural abscess secondary to epidural catheterization and a 50% frequency of neurologic deficits. We studied short‐ and long‐term neurologic outcome in patients operated for spinal epidural abscess after epidural analgesia. Methods: Nineteen patients who had undergone neurosurgical decompression and drainage of a spinal epidural abscess during a 5‐year period at three neurosurgical departments in East Denmark were identified by manual review of operating lists. Results: Median epidural catheterization time was 8 days (range 3–44). Preoperatively 12 patients suffered from inferior paraparesis, one had irradiating pain from the back, and 6 patients had no neurologic deficits. Postoperatively 2 patients had recovered, but 3 other patients had deteriorated; therefore, 13 patients were discharged with paresis/plegia. Seven patients died during a median follow‐up time for all patients of 41.6 months. One patient recovered completely, and one suffered from minor deficits. The remaining patients suffered from paraparesis/plegia or bladder/bowel dysfunction. Conclusion: Overall recovery rate for patients with paresis/plegia after epidural abscess was 20%. No patients with paresis/plegia following a thoracic abscess recovered in contrast to a 50% recovery rate for patients with lumbar epidural abscess. The majority of long‐term survivors had severe neurologic deficits. Abscess formation contributed to one death.