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Spinal Epidural Abscess: A Review of Presentation, Management, and Medicolegal Implications

Asian Spine Journal 2020년 14권 5호 p.742 ~ 759
Sharfman Zachary Tuvya, Gelfand Yaroslav, Shah Pryiam, Holtzman Ari Jacob, Mendelis Joseph Roy, Kinon Merritt Drew, Krystal Jonathan David, Brook Allan, Yassari Reza, Kramer David Claude,
소속 상세정보
 ( Sharfman Zachary Tuvya ) - Albert Einstein College of Medicine Montefiore Medical Center Spine Surgery Outcome Group
 ( Gelfand Yaroslav ) - Albert Einstein College of Medicine Montefiore Medical Center Spine Surgery Outcome Group
 ( Shah Pryiam ) - Albert Einstein College of Medicine Montefiore Medical Center Spine Surgery Outcome Group
 ( Holtzman Ari Jacob ) - Albert Einstein College of Medicine Montefiore Medical Center Spine Surgery Outcome Group
 ( Mendelis Joseph Roy ) - Albert Einstein College of Medicine Montefiore Medical Center Spine Surgery Outcome Group
 ( Kinon Merritt Drew ) - Albert Einstein College of Medicine Montefiore Medical Center Spine Surgery Outcome Group
 ( Krystal Jonathan David ) - Albert Einstein College of Medicine Montefiore Medical Center Spine Surgery Outcome Group
 ( Brook Allan ) - Albert Einstein College of Medicine Montefiore Medical Center Spine Surgery Outcome Group
 ( Yassari Reza ) - Albert Einstein College of Medicine Montefiore Medical Center Spine Surgery Outcome Group
 ( Kramer David Claude ) - Albert Einstein College of Medicine Montefiore Medical Center Spine Surgery Outcome Group

Abstract


Spinal epidural abscess (SEA) is a rare condition associated with significant morbidity and mortality. Despite advances in diagnostic medicine, early recognition of SEAs remains elusive. The vague presentation of the disease, coupled with its numerous risk factors, the diagnostic requirement for obtaining advanced imaging, and the necessity of specialized care constitute extraordinary challenges to both diagnosis and treatment of SEA. Once diagnosed, SEAs require urgent or emergent medical and/or surgical management. As SEAs are a relatively rare pathology, high-quality data are limited and there is no consensus on their optimal management. This paper focuses on presenting the treatment modalities that have been successful in the management of SEAs and providing a critical assessment of how specific SEA characteristics may render one infection more amenable to primary surgical or medical interventions. This paper reviews the relevant history, epidemiology, clinical presentation, radiology, microbiology, and treatment of SEAs and concludes by addressing the medicolegal implications of delayed treatment of the disease.

키워드

Spinal epidural abscess; Infections; Spine

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