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A spinal cord abscess is a walled off area of infection within the spinal cord.
What is going on in the body?
A spinal cord abscess occurs within the cord itself when infection spreads from the bloodstream. Most infections that cause spinal cord abscesses spread through the bloodstream from other parts of the body, including the heart and lungs.
What are the signs and symptoms of the infection?
A spinal cord abscess usually causes knife-like pain, with rapid loss of strength and feeling in the body below the level of the abscess.
What are the causes and risks of the infection?
Most spinal cord abscesses are caused by bacteria that travel from infections in other parts of the body, especially: A person is at higher risk for spinal cord abscess if he or she has:
- had a recent infection, particularly one of those listed as a cause of spinal cord abscess
- had recent surgery
- a weakened immune system, such as from an immunodeficiency disorder or chemotherapy. This would include individuals with diabetes or HIV.
If untreated, spinal cord abscesses may result in permanent paralysis of the legs, the trunk of the body, or possibly both the arms and the legs.
What can be done to prevent the infection?
The only method of preventing an abscess is prompt, proper treatment of infections wherever they occur.
How is the infection diagnosed?
Diagnosis is confirmed after a CT scan or MRI reveals the abscess. Abscesses usually appear on the scans much like tumours or other masses, but are surrounded by inflammation.
What are the long-term effects of the infection?
Symptoms are often brief and the signs of the abscess are rapid in their progression. The spinal cord tissue may be quickly destroyed by the infection or its surrounding swelling. The result is often paralysis. A prompt diagnosis by MRI scanning may speed treatment and improve the overall outlook.
What are the risks to others?
There are no risks to others from the spinal cord abscess, since it is not contagious. The underlying infection, such as pneumonia, may be contagious.
What are the treatments for the infection?
Treatment for a spinal cord abscess is aimed at relieving the pressure on the spinal cord, and curing the infection. This is accomplished by the use of antibiotics initially. If this doesn't clear the abscess, surgery may be necessary.
A laminectomy is performed under general anaesthesia. This means the person is put to sleep with medication. A laminectomy involves cutting through the bones of the spine. The abscess is then located and drained. This will relieve the pressure on the spinal cord. The abscess may reoccur in some instances.
What are the side effects of the treatments?
Infection may occur at the site of surgery, and may spread elsewhere in the body through the bloodstream. Also, there may be side effects specific to the antibiotic given.
What happens after treatment for the infection?
The person should be watched for any signs of infection. If any infection is noted, its cause should be identified and treated appropriately. The high rate of paralysis following treatment usually requires a prolonged course of rehabilitation, including physiotherapy and occupational therapy.
How is the infection monitored?
The infection site will be observed to see that it heals normally. Repeat cultures of the site and the blood may be needed to show that the infection is resolved. Any new or worsening symptoms should be reported to the doctor.
Author: James Warson, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 19/10/2004
Potential conflict of interest information for reviewers available on request