SPINAL EPIDURAL ABSCESS PATIENT FOLLOW-UP: ANOTHER CRITICAL TREATMENT PLAN CONSIDERATION

Author(s):
Rhett MacNeille; Johnson Lay; Jacob Razzouk; Shelly Bogue; Gideon Harianja; Evelyn Ouro-Rodrigues; Caleb Ting; Omar Ramos; Jennifer Veltman; Olumide Danisa

Background:

Spinal epidural abscess (SEA) is a rare process with significant risk for morbidity and mortality. Treatment includes an extended course of antibiotics with or without surgery depending on the clinical presentation. Both non-operative and surgically treated patients require close follow-up to ensure resolution of the infection without recurrence and/or progression of neurologic deficits. No previous study has looked specifically at follow-up in the SEA population, but review of the literature does show evidence of varying degrees of difficulty with follow-up for these patients.

Hypothesis:

Patients presenting with spinal epidural abscesses are at-risk for failure to follow-up

Methods:

This retrospective review looked at follow-up for 147 patients with SEA at a single institution from 2012 to 2021. Statistical analyses were performed to assess differences between groups of surgical versus non-surgical patients and those with adequate versus inadequate follow-up.

Results:

62 of 147 (42.2%) patients had inadequate follow-up (<90 days) with their surgical team, and 112 of 147 (76.2%) patients had inadequate follow-up (<90 days) with infectious disease (ID). The primary statistically significant difference between patients with adequate versus inadequate follow-up was found to be surgical status with those treated surgically more likely to have adequate follow-up than those treated non-operatively.

Conclusions:

Perhaps, improved follow-up in surgical patients should be considered as a factor when deciding on surgical versus non-operative treatment in the SEA patient population. Extra efforts coordinating follow-up care should be made for SEA patients.