ArticleSurgical neurology international2015
Timing and prognosis of surgery for spinal epidural abscess: A review.
Article in Surgical neurology international, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- Conservative versus early surgical treatment in the management of pyogenic spondylodiscitis: a systematic review and meta-analysis.Scientific reports · 2023Pooled it
- Not So Innocent Procedure: A Spinal Epidural Abscess Following Acupuncture-A Case Report and Literature Review of the Past 28 Years.International journal of spine surgery · 2026Article
- Perspective/short review: STAT surgery is the standard of care for treating significant spinal epidural abscesses.Surgical neurology international · 2026Review
- Risk Factors for Neurologic Deficits in Patients With Spinal Epidural Abscess: An Analysis of One-Hundred-Forty Cases.Global spine journal · 2025Article
- Keyhole decompression surgery for holospinal epidural abscess: a novel approach for spinal stability preservation.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Readmission and Associated Factors in Surgical Versus Non-Surgical Management of Spinal Epidural Abscess: A Nationwide Readmissions Database Analysis.Global spine journal · 2023Article
- Clinical Outcomes in Dogs Undergoing Cholecystectomy via a Transverse Incision: A Meta-Analysis of 121 Animals Treated between 2011 and 2021.Veterinary sciences · 2023Article
- Giant Invasive Intradural Extramedullary Lumbar Schwannoma: A Case Report and Literature Review.Cureus · 2023Article
- Article
- Extensive spinal epidural abscess caused by Staphylococcus epidermidis: A case report and literature review.Frontiers in surgery · 2023Article
- Spinal infection with intraspinal abscess or empyema and acute myelopathy: comparative analysis of diagnostics, therapy, complications and outcome in primary care.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Encrypted smartphone text messaging between spine surgeons may reduce after-hours surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Article
- The Diagnostic Performance of Multi-Detector Computed Tomography (MDCT) in Depiction of Acute Spondylodiscitis in an Emergency Department.Tomography (Ann Arbor, Mich.) · 2022Article
- Article
- Case Report: A case of cervical spinal epidural abscess combined with cervical paravertebral soft tissue abscess.Frontiers in surgery · 2022Article
- Multicenter Study of Clinical Presentation, Treatment, and Outcome in 41 Dogs With Spinal Epidural Empyema.Frontiers in veterinary science · 2022Article
- Panspinal Epidural Abscess: A Devastating Complication of Group B Streptococcal Bacteremia.Case reports in infectious diseases · 2022Article
- A case report of quadriplegia and acute stroke from tracking retropharyngeal and epidural abscess complicated by necrotizing fasciitis.Journal of the American College of Emergency Physicians open · 2021Article
- Article
- Spinal Epidural Abscess: A Review of Presentation, Management, and Medicolegal Implications.Asian spine journal · 2020Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe nonsurgical versus surgical management of spinal epidural abscesses (SEAs) remains controversial. Even with the best preoperative screening for multiple risk factors, high nonoperative failure rates are attended by considerable morbidity (e.g., irreversible paralysis) and mortality. Therefore, the focus remains on early surgery.
methodsMost papers promote early recognition of the clinical triad (e.g., fever [50%], spinal pain [92-100%], and neurological deficits [47%]) for SEA. They also identify SEA-related risk factors for choosing nonsurgical versus surgical approaches; advanced age (>65 or 80), diabetes (15-30%), cancer, intravenous drug abuse (25%), smoking (23%), elevated white blood cell count (>12.5), high C-reactive protein >115, positive blood cultures, magnetic resonance imaging/computed tomographic documented cord compression, and significant neurological deficits (e.g., 19-45%).
resultsSurgical options include: decompressions, open versus minimally invasive biopsy/culture/irrigation, or fusions. Up to 75% of SEA involve the thoracolumbar spine, and 50% are located ventrally. Wound cultures are positive in up to 78.8% of cases and are often (60%) correlated with positive blood cultures. The most typical offending organism is methicillin resistant Staphylococcus aureus, followed by methicillin sensitive S. aureus. Unfortunately, the failure rates for nonoperative treatment of SEA remain high (e.g., 41-42.5%), contributing to significant morbidity (22% risk of permanent paralysis), and mortality (3-25%).
conclusionThe vast majority of studies advocated early surgery to achieve better outcomes for treating SEA; this avoids high failure rates (41-42.5%) for nonoperative therapy, and limits morbidity/mortality rates.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.