Diagnosis and treatment of spinal epidural abscess

Spinal epidural abscess is an uncommon condition, most frequently due to Staphylococcus aureus. Back pain with radicular radiation and diminished spinal cord functions during the course of a febrile illness should arouse suspicion of this condition. In most cases a rapidly progressive course with the development of motor paralysis, a level of sensory loss and sphincter incontinence is noted. Myelography and laminectomy are urgently indicated for decompression and radical excision of the abscess to prevent the establishment of permanent neurological deficits. Three patients with spinal epidural abscess treated during 1977 illustrate the course of the disease, the progression of the neurological findings, and the importance of early diagnosis and prompt surgical intervention in lowering the high morbidity and preventing permanent neurological deficits.