title: Primary pyogenic spinal epidural abscess: How late is too late and how bad is too bad? - A study on surgical outcome after delayed presentation.
abstract: Spinal epidural abscess is a rare clinical entity with considerable morbidity. Even with prompt diagnosis and treatment, many patients are left with persistent residual neurological deficits. The present study details the outcome in 23 patients of primary pyogenic spinal epidural abscess, addressing the outcome following late presentation at a neurological facility. At presentation only 2 patients had relatively preserved neurological status. Eleven patients were paraplegic. All the patients underwent laminectomy and evacuation of abscess. A good functional outcome was observed in almost half of the patients, and there was a significant reduction in the number of the patients with severe disability. Factors influencing the outcome are described in this study.
authors.affiliation: a Department of Neurosurgery , National Institute of Mental Health and Neurosciences , Bangalore , India.
authors.forename: Raghunath
authors.initials: R
authors.lastname: Avanali
authors.affiliation: a Department of Neurosurgery , National Institute of Mental Health and Neurosciences , Bangalore , India.
authors.forename: Manish
authors.initials: M
authors.lastname: Ranjan
authors.affiliation: a Department of Neurosurgery , National Institute of Mental Health and Neurosciences , Bangalore , India.
authors.forename: Sudheesh
authors.initials: S
authors.lastname: Ramachandran
authors.affiliation: a Department of Neurosurgery , National Institute of Mental Health and Neurosciences , Bangalore , India.
authors.forename: Bhagavatula I
authors.initials: BI
authors.lastname: Devi
authors.affiliation: a Department of Neurosurgery , National Institute of Mental Health and Neurosciences , Bangalore , India.
authors.forename: Vinayak
authors.initials: V
authors.lastname: Narayanan
mesh_terms: D000293:Adolescent; D000328:Adult; D020802:Epidural Abscess / Q000601:surgery*; D004824:Epidural Space / Q000601:surgery*; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D013117:Spinal Cord Compression / Q000601:surgery; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: delayed surgery; holocord abscess; late presentation; spinal epidural abscess