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BioMed Research International
Volume 2016 (2016), Article ID 1614328, 6 pages
http://dx.doi.org/10.1155/2016/1614328
Review Article

Spinal Epidural Abscess: A Review with Special Emphasis on Earlier Diagnosis

Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

Received 14 July 2016; Accepted 24 October 2016

Academic Editor: André Talvani

Copyright © 2016 Allison Bond and Farrin A. Manian. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Spinal epidural abscess (SEA) is an uncommon but serious condition with significant morbidity and mortality. The prognosis of SEA is highly dependent on the timeliness of its diagnosis before neurological deficits develop. Unfortunately, often due to its nonspecific presentation, such as back pain, the diagnosis of SEA may be delayed in up to 75% of cases. Although many risk factors for SEA can be found in the published literature, their utility is limited by their frequent lack of objective evidence, numerousness, and absence in a significant proportion of cases. In this review, we call for a more discriminate evidence-based use of the term “risk factor” when discussing SEA and explore several approaches to its earlier diagnosis, including a simple algorithm based on its pathophysiology and serum C-reactive protein or erythrocyte sedimentation rate.