American Academy of Orthopaedic Surgeons 1989 Annual Meeting - Scientific Program Nongranulomatous Spinal Epidural Abscess Paper No. 369 TUESDAY, FEBRUARY 14, 1989 11:30 AM Las Vegas Convention Center Rooms E1-E3 *Ronald D. Gardner, MD, Miami, FL *Frank P. Cammisa, Jr., MD, Miami, Fl Frank J. Eismont, MD, Miami, FL *Barth Green, MD, Miami, FL Fourteen patients with spinal epidural abscesses were reviewed. All presented with pain, fever and elevated white blood cell count. Thirteen had preoperative paralysis including 1 with Frankel A and 5 with Frankel B paralysis. Nine patients had associated vertebral osteomyelitis. Myelogram accurately demonstrated the abscesses. Magnetic resonance imaging was falsely negative in one patient, but allowed early detection of vertebral osteomyelitis in others. All patients were treated with surgical decompression (average 8 levels) with 9 laminectomies, 3 anterior decompressions and 2 having both procedures. Seven patients died. Mortality correlated with increasing age, presence of diabetes, and severe paralysis. All surviving patients with paralysis improved at least one Frankel grade. *By Invitation Moderator: John W. Frymoyer, MD, Burlington, VT | |
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