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Early surgery for CSEA offers improved motor scores vs. medical management
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Compared with medical intervention, early surgery for cervical spine epidural abscesses resulted in improved post-treatment motor scores and a much lower rate of failure, according to the results of a recently published study.
Researchers retrospectively reviewed electronic medical record data for 62 patients diagnosed with spontaneous cervical spine epidural abscesses (SCEA) from a single tertiary medical center from Jan. 1, 2005, to Dec. 31, 2011. Patients were categorized as those who were treated medically without surgery, those who were treated with early surgery and those initially managed medically who later required surgical treatment.
Eighteen of 24 patients in the medical management group failed, requiring delayed emergent surgery, according to the researchers. Of the six patients in the medical group who were managed successfully, motor scores increased by 2.3 points.
Of the 34 patients treated with early surgery, the researchers found an increase in average motor scores of 11.89 points. Patients in the cross-over group had a net drop in motor score of 15.89 points.
Patients in the medical treatment group had a failure rate of 75%, according to the researchers. Alternatively, change in motor score between the early and delayed surgery groups was significant, but favored earlier surgical intervention.
The researchers found risk factors and laboratory data were not predictive of medical failure or post-treatment motor score outcomes due to the high number of medical failures that occurred when abscess was involved in the cervical epidural space. – by Robert Linnehan
Disclosure: Alton has no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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