Letter to the Editor

Percutaneous Computed Tomography-guided Needle Aspiration Drainage of Spinal Epidural Abscess

Authors: Farhan Siddiq, MD, Asif R. Malik, MD, Raymond A. Smego Jr, MD, MPH, FACP, FRCP, DTM&H

Abstract

Spinal epidural abscess is an uncommon disease but one with potentially devastating neurologic consequences if not diagnosed and treated appropriately. Historically, surgical intervention has been widely accepted as the mainstay of treatment in most instances. However, accumulated clinical experience indicates that selected patients with spinal epidural abscess can be managed effectively with nonsurgical treatment alternatives.1–3 We report our experience with percutaneous computed tomography (CT)-guided needle aspiration drainage in seven patients with spinal epidural abscess and review the literature on this management option.

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References

1. Khan SH, Hussain MS, Griebel RW, et al. Title comparison of primary and secondary spinal epidural abscesses: a retrospective analysis of 29 cases. Surg Neurol 2003;59:22–33.
 
2. Ahl T, Hedstrom M, von Heijne A, et al. Acute spinal epidural abscess without concurrent spondylodiscitis. Successful closed treatment in 10 cases. Acta Orthop Scand 1999;70:199–202.
 
3. Siddiq F, Chowfin A, Tight R, et al. Medical vs surgical management of spinal epidural abscess. Arch Intern Med 2004;164:2409–2412.
 
4. Lyu RK, Chen C, Tang L. Spinal epidural abscess successfully treated with percutaneous, computed tomography-guided, needle aspiration and parenteral antibiotic therapy: case report and review of the literature. Neurosurgery 2002;51:509–512.
 
5. Cwikiel W. Percutaneous drainage of abscess in psoas compartment and epidural space. Case report and review of the literature. Acta Radiol 1991;32:159–161.