Spinal Epidural Abscess: Delayed Diagnosis And Importance Of Early Treatment

If you, or a friend or family member, has been diagnosed with spinal epidural abscess we recommend that you talk with one of the medical malpractice litigation attorneys at the Kocian Law Group.

An epidural abscess is a potentially life or limb threatening disease that requires early detection and proper management. Essentially, an "epidural abscess" is a collection of infected material (pus) between the dura (the outer membrane that covers the brain and the spinal cord) and the bones of the spine or skull. Basically, it is an infection inside the spine.

A spinal epidural abscess (SEA) is usually caused by the introduction of bacteria into a person's spinal cord. Your body sends white blood cells to fight the bacterial infection which causes pus to build up and an "abscess" to form. The pus collection causes pressure on the spinal cord. Unless proper, and timely, treatment is provided if the pressure is not removed (by urgent surgery or if caught early enough with antibiotics) the growing abscess can crush the spine causing irreparable nerve damage including but not limited to paraplegia, quadriplegia and even death.

Significant risk factors for SEA include fever, back pain and neurological deficits – which has been referred to as "the classic triad". Doctors know that the "classic triad" is often not present in many cases and therefore must act competently to perform thorough examination, testing and treatment to avoid the life changing damages which arise from SEA.

Are You Receiving The Appropriate Medical Treatment?

To prevent the known predictable and foreseeable life changing physical damages that can occur from SEA doctors should timely perform the following exam and tests:

  • Complete physical examination which often will show tenderness over the spine and can also demonstrate spinal cord compression, paralysis of the lower body (paraplegia) or of the entire trunk, arms and legs (quadriplegia);
  • MRI examination of the spine (to reveal the abscess visually to the doctors for treatment). MRI's are the imaging modality of choice as it has been shown to very accurately define the extent of SEA, along with the degree of thecal sac compression. If MRI's are not available CT myelography is another sensitive diagnostic option. Lumbar punctures should not be done (and are contraindicated) as it carries the risk of spreading bacteria into the spine with resultant damages to the patient; and
  • Blood cultures should be taken of the abscess material (when sufficient time permits such testing). Cultures have an excellent correlation with pathogenic (causing or capable of causing disease) abscess organism and are helpful in antibiotic therapy. Another important lab test which should be done is an ESR (erethocyte sedimentation rate - The sedimentation rate test is done to find out if inflammation or infection is present, to check the progress of a disease and to see how well the treatment is working) which has been shown to be elevated in over 90% of patients with SEA.

Anyone Can Be Affected

SEA affects people of all ages, though the majority of persons are between 30 and 60 years old, with a predominance of males. Other risk factors include patients with diabetes, MRSA infections, Staph infections and back pain. Symptoms will typically progress from back pain and localized tenderness to muscle weakness, sphincter incontinence, sensory deficits and finally paralysis if left untreated.

Physical examination alone is not sensitive for treating SEA. A diligent neurological examination, with proper charting and documentation by medical providers is required for successful treatment.

The ultimate outcome, or prognosis, for SEA is usually dependent upon whether the patient received timely and proper treatment. Failure to timely diagnose the condition often leads to failure to provide timely treatment. It has been said that the most significant factors contributing to the duration of symptoms are the delay in diagnosis and treatment.

Call our office at 860-281-2908 or send us an email to set up a free case evaluation with a lawyer. We have four convenient locations throughout Connecticut including Hartford, Waterbury, New Britain and Manchester.