Epidural Abscess

Spinal epidural abscess (SEA) is an infection characterized by the accumulation of purulent material in the space between the spinal dura and osseous–ligamentous structures of the spine. Although SEA is a relatively rare infectious disease of the central nervous system, it is still more common than spinal subdural abscess and spinal cord abscess; it can cause rapid neurologic deterioration, with severe medical complications and even death. To decide the best treatment option for patients with SEA, we should perform a stratification according to clinical manifestation, risk factors, degree and time of neurological deficit, blood tests, and imaging studies. Surgical decompression and drainage of the abscess are considered the standard treatment option in the setting of acute neurologic dysfunction. In addition, in patients with certain risk factors and elevated blood markers, patients with sepsis, or patients with failed conservative treatment, surgical management is also recommended.