THORACIC EPIDURAL ABSCESS

Twenty-one cases of thoracic spinal epidural abscess occurring over a 10-year period were retrospectively reviewed. Diagnosis was made by MR I or myelography and confirmed in the operative cases. A bacterial age nt was isolated in 18 of the cases (86%). When measured, the erythrocy te sedimentation rate was elevated in all cases. Four patients who pre sented without neurologic deficits remained intact. All patients who p resented with neurological deficits underwent surgical intervention in addition to intravenous antibiotics. Of the 15 patients who presented with a paraparesis of less than antigravity strength, five eventually were independent ambulators and continent. A good outcome resulted in 80% of those who underwent decompression within 24 h, as opposed to o nly 10% of the patients decompressed after 24 h. Good results can be o btained despite severe neurologic compromise when treated by rapid dia gnosis and decompression of the spinal canal.