Diagnosis And Treatment Of Epidural Abscess

Diagnosis of an epidural abscess requires a magnetic resonance imaging scan with positive results necessitating immediate surgery to clear the infection.

Diagnosis And Treatment Of An Epidural Abscess

Proper diagnosis of an epidural abscess is required to treat it, but diagnosis can be tricky, especially if the only symptom is non-specific back pain. Prompt diagnosis is critical because a delay in treatment can lead to irreversible neurologic damage, permanent paralysis, or even death. Neurologic dysfunction such as leg weakness or incontinence can progress rapidly and the longer they are allowed to present, the more damage they abscess can do.

Diagnosing An Epidural Abscess

Although a physical exam and possibly blood work will be ordered, epidural abscesses can only be diagnosed via Magnetic Resonance Imaging (MRI). MRIs are capable of picking up evidence of infections in the spinal cord area that are not visible on CT scans or X-rays.

When a patient presents with back pain that does not respond to pain medication coupled with neurologic problems the attending physician should order an MRI immediately. Suspicion of abscess should be even greater if the patient has a fever or has had a recent infection.

The sooner the abscess is identified, the sooner treatment can begin. Epidural abscess requires rapid treatment to minimize lasting damage and, in some cases, reverse existing damage.

Treatment Of An Epidural Abscess

The earlier an epidural abscess is diagnosed, the better the patient’s treatment and recovery prognosis. Treatment is a three-pronged approach of: surgery, antibiotics, and therapy.

    • Surgery. If the MRI shows an abscess, emergency surgery will be ordered. The surgery will drain pus to remove the abscess and restore function to the spinal cord. This is generally effective unless the abscess has been present for so long that it has compressed and killed nerve cells.


    • Antibiotics. After surgery, the patient will likely be put on antibiotic therapy for as long as 4-6 weeks to clear up any lingering infection.


  • Therapy. In some cases physical therapy may be required to help the patient restore function. The type and length of therapy depends on what function was lost and how much damage occurred.