Spinal Epidural Abscess

The goal of this review is to summarize the importance of identifying and treating a spinal epidural abscess. This review also delves into the intricacies of imaging modalities and the controversies regarding management options.

Although magnetic resonance imaging (MRI) is a valuable diagnostic tool for evaluating SEA, focused attention to T2 imaging to the exclusion of other sequences can result in diagnostic errors and overlooking critical epidural abscesses.

Spinal epidural abscess is a rare disease; however, it has high morbidity and mortality if left untreated. Although rare, there is a slow progressive increase in the incidence of SEA. Imaging should be considered for any patient with red flags in their history or physical examination. MRI is the imaging test of choice to assure early diagnosis and treatment. Reliance on T2 imaging can result in an underappreciation of SEA. The characteristic space-occupying process, the essential comparison of T1 and T2 imaging, and the use of contrast characteristics are key ingredients for an accurate diagnosis.