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Howie BA, Davidson IU, Tanenbaum JE, et al. Thoracic Epidural Abscesses: A Systematic Review. Global Spine J. 2018;8(4):68S-84Sdoi: 10.1177/2192568218763324.
Howie, B. A., Davidson, I. U., Tanenbaum, J. E., Pahuta, M. A., Buchholz, A. L., Steinmetz, M. P., & Mroz, T. E. (2018). Thoracic Epidural Abscesses: A Systematic Review. Global spine journal, 8(4), 68S-84S. https://doi.org/10.1177/2192568218763324
Howie, Benjamin A, et al. "Thoracic Epidural Abscesses: A Systematic Review." Global spine journal vol. 8,4 (2018): 68S-84S. doi: https://doi.org/10.1177/2192568218763324
Howie BA, Davidson IU, Tanenbaum JE, Pahuta MA, Buchholz AL, Steinmetz MP, Mroz TE. Thoracic Epidural Abscesses: A Systematic Review. Global Spine J. 2018 Dec;8(4):68S-84S. doi: 10.1177/2192568218763324. Epub 2018 Dec 13. PMID: 30574442; PMCID: PMC6295817.
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Global Spine J. 2018 Dec;8(4):68S-84S. doi: 10.1177/2192568218763324. Epub 2018 Dec 13.

Thoracic Epidural Abscesses: A Systematic Review.

Global spine journal

Benjamin A Howie, Iyooh U Davidson, Joseph E Tanenbaum, Markian A Pahuta, Avery L Buchholz, Michael P Steinmetz, Thomas E Mroz

Affiliations

  1. Cleveland Clinic, Cleveland, OH, USA.
  2. Northeast Ohio Medical University, Rootstown, OH, USA.
  3. Case Western Reserve University, Cleveland, OH, USA.
  4. Henry Ford Health System, Detroit, MI, USA.
  5. Medical University of South Carolina, Charleston, SC, USA.

PMID: 30574442 PMCID: PMC6295817 DOI: 10.1177/2192568218763324

Abstract

STUDY DESIGN: Systematic review.

OBJECTIVES: Past research has demonstrated increased speed and severity of progression for spinal epidural abscesses (SEAs) of the thoracic level, specifically, when compared with SEAs of other spinal cord levels. Untreated, this infection can result in permanent neurological sequelae with eventual progression to death if inadequately managed. Despite the seriousness of this disease, no articles have focused on the presentation, diagnosis, and treatment of SEAs of the thoracic level. For this reason, specific focus on SEAs of the thoracic level occurred when researchers designed and implemented the following systematic review.

METHODS: A query of Ovid-Medline and EMBASE, Cochrane Central, and additional review sources was conducted. Search criteria focused on articles specific to thoracic epidural abscesses.

RESULTS: Twenty-five articles met inclusion criteria. The most commonly reported symptoms present on admission included back pain, paraparesis/paraplegia, fever, and loss of bowel/bladder control. Significant risk factors included diabetes, intravenous drug use, and advanced age (

CONCLUSIONS: For the first time researchers have focused specifically on SEAs of the thoracic level, as opposed to previously published general analysis of SEAs as a whole. Based on the results, investigators recommend early magnetic resonance imaging of the spine, laboratory workup (sedimentation rate/C-reactive protein, complete blood count), abscess culture followed by empiric antibiotics, and immediate surgical decompression when neurological deficits are present.

Keywords: EDA; SEA; epidural abscess; spine abscess; systematic review; thoracic epidural abscess

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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