Monday, March 1, 2021

Spinal Epidural Abscess

EmDocs - March 01, 2021 - By Della Porta A; Bryant J-P; Bornstein K; Montrief T
Reviewed by: Manny Singh; Alex Koyfman and Brit Long
“Take home points

  • Why is spinal epidural abscess a challenging diagnosis? 
  • Back pain is a common chief complaint, while SEA is a rare condition.
  • SEA presents with non-specific symptoms and infrequently with the classic triad.
  • Diagnosis requires expensive and time-consuming imaging (MRI).
  • Coexisting infections or risk factors are common in the ED setting.
How can we improve diagnostic delay of SEA? 
  • Implementation of decision-making algorithms can reduce time intervals of ED presentation to diagnosis.
  • Statistical models have accurately discriminated cases from non-cases of SEA.
  • Focused exam, such as the PVR, can detect subtle neurologic deficits and increase our assessment sensitivity.
  • When indicated, early whole spine imaging can detect skip lesions and prevent delays in diagnosing multiple abscess locations.”