What are the other Names for this Condition? (Also known as/Synonyms)

• SCA (Spinal Cord Abscess)

What is Spinal Cord Abscess? (Definition/Background Information)

• Spinal Cord Abscess (SCA) is infection or inflammation of the spinal cord, along with the formation of pus, in and around the spinal cord. It is generally caused by a bacterial infection, most commonly by Staphylococcus sp.
• Spinal Cord Abscess most commonly occurs in intravenous drug users, individuals with HIV infection, diabetes, individuals with weak immune system, and those with multi-organ failure
• The signs and symptoms associated with Spinal Cord Abscess include fever, chills, and loss of movements and sensations, due to damage to the nerves in the affected region of the spinal cord
• A diagnosis of the condition may be made by an MRI scan of the affected region and culture examination of the abscess material
• Spinal Cord Abscess is treated by antibiotics and surgical drainage of the abscess. The recovery in a majority of individuals is full and complete with appropriate and effective treatment
• However, the prognosis can vary from individual to another depending on their response to treatment. For some, when the abscess is not properly treated, Spinal Cord Abscess may lead to compression of the spinal cord that can subsequently lead to permanent paralysis, nerve loss, and even may become life-threatening

Who gets Spinal Cord Abscess? (Age and Sex Distribution)

• Spinal Cord Abscess is mostly observed in individuals in the third decade of their life (age group 20-30 years). However, it can occur at any age
• Males are more at risk for SCA than females
• All racial and ethnic groups are at risk and no specific preference is seen

What are the Risk Factors for Spinal Cord Abscess? (Predisposing Factors)

The risk factors associated with Spinal Cord Abscess include:

• Use of intravenous drugs
• Immunocompromised status: Individuals with HIV, AIDS, and poorly-controlled diabetes
• Back injuries
• Boils that appear on the skin, either in the scalp or at the back. These boils can cause skin infection which can spread to the spinal cord
• Lumbar puncture or any surgery done on the spinal cord
• Bacteremia: The spread of infection from other parts of the body, such as from a bone, a ruptured gallbladder, or from other locations

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Spinal Cord Abscess? (Etiology)

• Spinal Cord Abscess is caused by a bacterial infection, most commonly by Staphylococcus and Streptococcus bacterial species. It is less commonly caused by Gram-negative bacteria
• Other uncommon organisms that may cause SCA include Actinomyces, Listeria, Proteus, Pseudomonos, Histoplasma capsulatum, and Sparganum (a type of tapeworm)
• The causative organisms can enter the region through an injury, or as a result of a boil or septicemia
• In rare cases, the condition may be caused by a tuberculosis infection

What are the Signs and Symptoms of Spinal Cord Abscess?

The signs and symptoms in an individual with Spinal Cord Abscess depend upon the location of the abscess formation. These may include:

• Fever and chills
• Decreased or complete loss of bowel and/or bladder control
• Leg paresis (muscular weakness, partial paralysis)
• Loss of sensations in the area below the abscess
• Low backache, which starts as a mild back pain, but slowly moves to the hip, leg, feet, shoulder, arm, or hand

How is Spinal Cord Abscess Diagnosed?

The diagnosis of Spinal Cord Abscess may involve the following exams and tests:

• Complete evaluation of medical history and thorough physical examination, with special attention to symptoms such as:
  • Tenderness over the spine
  • Paraplegia - lower body paralysis
  • Quadriplegia - paralysis of all 4 extremities (arms and legs)
• Tests such as:
  • X-ray of the affected region
  • CT or MRI scan of the affected region
  • Gram stain and culture of the abscess

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Spinal Cord Abscess?

The following are some potential complications associated with Spinal Cord Abscess:

• Severe back pain
• Permanent damage to the spinal cord
• Recurrence of infection
• Decreased control of the bowel and bladder
• Loss of sensation in and around the area of the abscess
• Impotency
• Complete paralysis of the body, if the abscess occurs in the cervical spine region

How is Spinal Cord Abscess Treated?

Spinal Cord Abscess is generally treated using the following measures:

• Intravenous administration of medication depending upon the type of organism causing the abscess
• Drainage of the abscess through surgery

How can Spinal Cord Abscess be Prevented?

The following methods may help one prevent Spinal Cord Abscess:

• Avoiding illicit drug use and sharing of needles
• Getting treatment for any back injury immediately
• Completing the treatment course for boils and other infections
• Seeking medical attention at the first sign of potential abscess involving the spinal cord. This will help in preventing severe complications due to Spinal Cord Abscess

What is the Prognosis of Spinal Cord Abscess? (Outcomes/Resolutions)

• The prognosis of Spinal Cord Abscess varies from one individual to another, and their response to treatment. A full recovery is possible with early diagnosis and prompt and adequate treatment
• The prognosis also depends upon the type of organism causing the abscess. Generally, organisms that are difficult to treat can result in worse prognosis
• In some cases, when the abscess is not properly treated, it may lead to compression of the spinal cord that may lead to permanent paralysis, nerve loss, and can even be life-threatening
• When the abscess is not completely drained, the risk of recurrence is reported to be high

Additional and Relevant Useful Information for Spinal Cord Abscess:

• Percutaneous abscess drainage is a minimally invasive procedure that is used to treat abscesses. An abscess is defined as any collection of infectious fluid within the body

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http://www.dovemed.com/common-procedures/radiology-procedures/percutaneous-abscess-drainage/