Infection as a cause of spinal cord compression: A review of 36 spinal epidural abscess cases

A retrospective survey of 36 cases treated in the Department of Neurosurger y, Hacettepe University Hospitals since 1970 was performed. Clinical presen tation, aetiology and outcome of this rare disease compared to recently pub lished series. All cases were admitted with signs of neural compression. Cl inical and laboratory data suggesting an infectious origin were present onl y in 4 cases. Radiological investigation including magnetic resonance imagi ng in 10 patients, were not confirmative for an epidural abscess except for two cases. All cases underwent urgent surgical decompression and tuberculo us abscess either in granulation or pus form was found in the majority. Ove rall mortality rate was 5.8%. Outcome was closely related to the neurologic al condition on admission rather than the underlying infectious origin. Whe n compared with recently reported series, our cases demonstrated a signific ant divergence in terms of clinical presentation, pathogenesis and outcome. The most probable reason for this discrepancy is that risk factors for com promised immunity or systemic infection were much less than the other serie s and mycobacterium tuberculosis is the responsible agent in the majority w hich has a much more favourable outcome than non-specific infections.