Spinal Cord Infections Follow-up

Updated: Sep 26, 2018
  • Author: Andrew K Chang, MD, MS; Chief Editor: Liudvikas Jagminas, MD, FACEP  more...
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Follow-up

Further Inpatient Care

Laminectomy is the treatment of choice once the provisional diagnosis is made. Then, opening of the dura, needle aspiration of the abscess (with pus bacteriology), midline myelotomy with drainage of the cavity, abundant irrigation, and closure by layers are performed.

The dura mater preferably is closed with a graft, if needed, once decompression has been accomplished. Although marsupialization has been tried occasionally, it generally is not recommended.

In children, all cases of abscesses with concomitant isolated dermal sinus presented when the child was older than 6 months of age, which suggests that complete resection of the dermal sinus before 6 months of age may prevent the formation of intramedullary spinal cord abscess and its significant morbidity and mortality.

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Complications

Complications include the following:

  • Sepsis

  • Neurologic sequelae (70%)

  • Death

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Prognosis

Prognosis of spinal cord infection was grim in the preantibiotic era. Currently, with prompt diagnosis, early surgery, and correct antibiotic therapy, the chances for full or almost full recovery often are very good.

Early surgery is the key to recovery for patients in the acute category.

Prognosis generally is better for patients in the chronic and subacute categories.

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