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)
Click here to contact Michael Bond, MD

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%.


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