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Spinal Cord Abscess

  • Brain and spinal cord

Definition

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.

Risks

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:
  • bacterial growths on heart valves, known as endocarditis
  • urinary tract infections
  • infections of the lungs, such as pneumonia
  • sinus infections, or sinusitis
  • infections in the mouth
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 infection.
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.

Prevention

What can be done to prevent the infection?

The only method of preventing an abscess is prompt, appropriate treatment of infections wherever they occur.

Diagnosed

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 tumors or other masses, but are surrounded by inflammation.

Long Term Effects

What are the long-term effects of the infection?

Symptoms often begin very suddenly, 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 hasten treatment and improve the overall outlook.

Other Risks

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.

Treatments

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. The first step in treatment is antibiotic therapy. If this fails to clear the abscess, surgery may be necessary.
A laminectomy is performed under general anesthesia. This means the person is put to sleep with medication, feels no pain, and has no awareness of the procedure. A laminectomy involves cutting through the bones of the spine. The abscess is then located and drained in order to get rid of the focus of the infection and to relieve the pressure on the spinal cord. Sometimes, spinal cord abscesses recur after surgery.

Side Effects

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.

After Treatment

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 physical therapy and occupational therapy.

Monitor

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 healthcare professional.

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