UMEM Educational Pearls

Category: Orthopedics

Title: Risk Factors for Spinal Epidural Abscesses

Keywords: Spinal Epidural Abscess (PubMed Search)

Posted: 10/30/2010 by Michael Bond, MD (Updated: 6/15/2024)
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Risk Factors for Spinal Epidural Abscesses

Building on Dr. Corwell's pearl from last week concerning Spinal Epidural Abscess, risk factors for Spinal Epidural Abscesses other than IV drug abuse are:

  1. Diabetes
  2. ESRD
  3. Septicemia
  4. HIV infection
  5. Malignancy
  6. Morbid obesity
  7. Long-term corticosteroid use
  8. Alcoholism
  9. Infection at a distal site
  10. Indwelling catheters
  11. Spinal surgery

The infection can occur via three routes 1) hematogenous spread 2) Direct Extension from a local infection such as osteoomyelitis, and 3) iatrogenic introduction which is thought to be responsible for 14-22% of the cases.  A catheter in the epidural space for more than 2 days has a infection rate of 4.3%.

References

Marc Tompkins, Ian Panuncialman, Phillip Lucas, Mark Palumbo.  Spinal Epidural Abscess The Journal of Emergency Medicine, Volume 39, Issue 3, September 2010, Pages 384-390