title: Spontaneous pyogenic spinal epidural abscess.
abstract: OBJECTIVE
  Spontaneous pyogenic spinal epidural abscess (SEA) is a rare condition but might be devastating and fatal. Traditional treatment is surgical decompression and antibiotics. A retrospective study was designed to assess the eff ect of clinical findings and treatment methods on the outcome.
  
  
  METHODS
  14 patients were reviewed (10 male, 4 female, mean age 59.14). Six dorsal, seven ventral and one dorsal with ventral SEA were observed. SEA found in thoracal (5), lumbar (4), cervical (3) regions. One patient showed both cervical and thoracal and one patient showed cervical, thoracal and lumbar involvement. All patients received minimum 3 weeks of I.V., followed by minimum 3 weeks of oral antibiotics. All patients complained of spinal pain. Ten patients presented with fever. Neurological deficit was observed in 9 cases.
  
  
  RESULTS
  A total of 22 interventions was performed. Instrumentation was applied in 5 cases. Full recovery was achieved in 7 patients, significant improvement was observed in 5 patients. The neurological findings did not change in one patient. One mortality and one morbidity were observed.
  
  
  CONCLUSIONS
  Spontaneous SEA is a rare disease but might result in catastrophic neurological deficits and fatal even with prompt treatment. Therefore, one should always keep SEA in mind if a patient presents with fever, vague and spinal pain.
authors.affiliation: American Hospital, Department of Neurosurgery, Istanbul, Turkey. tuncoktenoglu@gmail.com
authors.forename: Tunc
authors.initials: T
authors.lastname: Oktenoglu
authors.forename: Mehdi
authors.initials: M
authors.lastname: Sasani
authors.forename: Birsen
authors.initials: B
authors.lastname: Cetin
authors.forename: Hakan
authors.initials: H
authors.lastname: Bozkus
authors.forename: Omur
authors.initials: O
authors.lastname: Ercelen
authors.forename: Metin
authors.initials: M
authors.lastname: Vural
authors.forename: Ali Fahir
authors.initials: AF
authors.lastname: Ozer
authors.forename: Ali Cetin
authors.initials: AC
authors.lastname: Sarioglu
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001416:Back Pain / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D015299:Discitis / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D020802:Epidural Abscess / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D020127:Recovery of Function; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D013211:Staphylococcus aureus; D013290:Streptococcal Infections / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D019533:Streptococcus oralis
chemical_list: D000900:Anti-Bacterial Agents