Spinal empyema

Question 1

What can cause spinal empyema?

Answer 1

Secondary to extention of a paraspinal abscess
Migrating foreign body
Haematogenous spread
Bite wounds
Iatrogenic

Question 2

What are the most common clinical sign of spinal empyema?

Answer 2

Pyrexia
Spinal hyperesthesia
Deficits related to spinal compression (paresis or plegia)

Question 3

How do you diagnose spinal empyema?

Answer 3

Advanced imaging
- in certain cases only seen during surgery
CSF analysis

Question 4

What can be seen in CSF analysis of spinal empyema?

Answer 4

Normal

or

Abnormal inflammatory cell count
Increased protein

Question 5

What is treatment of spinal empyema?

Answer 5

Medical or surgical

Question 6

What are indications for surgical treatment?

Answer 6

When there is evidence of marked spinal cord compression and severe neurological dysfunction

–> Aggressive surgical decompression and drainage, in combination with appropriate antibiotic therapy based on C+S