Spinal epidural abscess: study of early outcome.
OBJECTIVE
To evaluate the course, complications, and outcomes of individuals with spinal epidural abscess (SEA) and to compare these factors in individuals who had sustained a traumatic spinal cord injury (TSCI).


METHODS
This is a retrospective study evaluating risk factors, functional change, and neuromedical complications. Thirty-two adults with SEA, treated on a rehabilitation unit at an urban university medical center, were compared with 32 individuals with TSCI. Groups were matched by lesion level and American Spinal Injury Association classification.


RESULTS
Both groups made significant functional improvement as measured by the functional independence measure (FIM), although the SEA group only averaged a 15-point increase, whereas the TSCI group averaged approximately 30 points. When compared with the TSCI group, the SEA group had a higher frequency of pressure ulcers (P < 0.04), and exhibited greater intravenous drug use (P < 0.008). There were no differences between the groups with respect to discharge placement or neuromedical risk factors.


CONCLUSIONS
A number of predisposing factors and neuromedical complications that have significant medical implications were noted in the SEA group. In general, predisposing factors and outcomes were similar between those with SEA and those with TSCI, except for drug use and rate of pressure ulcers. These factors do not appear to relate to differential outcome in discharge placement, however. Although it is important to be aware of factors that place an individual at risk for SEA and appreciate the risks for complications, significant functional improvement can be achieved in this population.
Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. zafonterd@upmc.edu
Ross D
RD
Zafonte
Joseph H
JH
Ricker
Robin A
RA
Hanks
Deborah L
DL
Wood
Arti
A
Amin
Lisa
L
Lombard
D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D000368:Aged; D015897:Comorbidity; D004185:Disability Evaluation; D020802:Epidural Abscess / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*