A spinal cord abscess is a walled off area of infection within the spinal cord.
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.
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:
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.
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.
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.
The only method of preventing an abscess is prompt, proper treatment of infections wherever they occur.
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.
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.
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 anesthesia. 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.
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.
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.
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 provider.
Author:James Warson, MD
Date Written:
Editor:Planko, Christa, MA
Edit Date:04/18/00
Reviewer:William M. Boggs, MD
Date Reviewed:09/20/01