title: Spinal epidural abscess and paralytic mechanisms.
abstract: OBJECTIVE
  The incidence of spinal epidural abscess is increasing, and the understanding of the pathophysiology is evolving. Better understanding of the pathophysiology, specifically the role of ischemia, warrants a change in therapy.
  
  
  RESULTS
  Paralysis in spinal epidural abscess may be the result of spinal cord compression, spinal cord arterial and/or venous ischemia and thrombophlebitis or a combination of these.
  
  
  CONCLUSIONS
  Recent evidence indicates the following areas of investigation and management can improve outcome in spinal epidural abscess: minimally invasive surgery early versus medical management when there are no significant neurological deficits, neuroradiologic arterial evaluation with therapies directed at vascular ischemia and thrombosis, and aggressive rehabilitation.
authors.affiliation: Miller School of Medicine, University of Miami, Miami, Florida 33136, USA. nshah@med.miami.edu
authors.forename: Nirav H
authors.initials: NH
authors.lastname: Shah
authors.forename: Karen L
authors.initials: KL
authors.lastname: Roos
mesh_terms: D020802:Epidural Abscess / Q000150:complications / Q000601:surgery*; D006801:Humans; D010243:Paralysis / Q000209:etiology*; D013117:Spinal Cord Compression / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome