• L P Wang, J Hauerberg, and J F Schmidt.
• Department of Neuroanesthesiology, National University Hospital, Rigshospitalet, Copenhagen, Denmark. lp.wang@dadlnet.dk
• Acta Anaesthesiol Scand. 2001 Feb 1; 45 (2): 233-9.

BackgroundA recent investigation demonstrated a high incidence of epidural abscess secondary to epidural catheterization and a 50% frequency of neurologic deficits. We studied short- and long-term neurologic outcome in patients operated for spinal epidural abscess after epidural analgesia.MethodsNineteen patients who had undergone neurosurgical decompression and drainage of a spinal epidural abscess during a 5-year period at three neurosurgical departments in East Denmark were identified by manual review of operating lists.ResultsMedian epidural catheterization time was 8 days (range 3-44). Preoperatively 12 patients suffered from inferior paraparesis, one had irradiating pain from the back, and 6 patients had no neurologic deficits. Postoperatively 2 patients had recovered, but 3 other patients had deteriorated; therefore, 13 patients were discharged with paresis/plegia. Seven patients died during a median follow-up time for all patients of 41.6 months. One patient recovered completely, and one suffered from minor deficits. The remaining patients suffered from paraparesis/plegia or bladder/bowel dysfunction.ConclusionOverall recovery rate for patients with paresis/plegia after epidural abscess was 20%. No patients with paresis/plegia following a thoracic abscess recovered in contrast to a 50% recovery rate for patients with lumbar epidural abscess. The majority of long-term survivors had severe neurologic deficits. Abscess formation contributed to one death.

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