Diagnosis, and Treatment of Cervical Epidural Abscess and/or Cervical Vertebral Osteomyelitis with or without Retropharyngeal Abscess; A Review.
Cervical spine epidural abscesses
How to recognize failure of medical management
Retropharyngeal abscesses
Success of early surgery where appropriate for CSEA and/or VO with/without RPA
Vertebral osteomyelitis
Journal
Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836
Informations de publication
Date de publication:
2020
2020
Historique:
received:
20
05
2020
accepted:
20
05
2020
entrez:
9
7
2020
pubmed:
9
7
2020
medline:
9
7
2020
Statut:
epublish
Résumé
Every year approximately 19.6 patients/100,000 per year are admitted to hospitals with spinal epidural abscesses (CSEA), 7.4/100,000 have vertebral osteomyelitis (VO)/100,000/year, while 4.1/100.000 children/year have cervical retropharyngeal abscesses (RPA) (i.e., data insufficient for adults). Here we evaluated 11 individual case studies, 6 multiple patient series, and looked at 9 general review articles focusing on CSEA, and/or VO, with/without RPA. Of the 11 case studies involving 15 patients, 14 had cervical spinal epidural abscesses (CSEA: 10 CSEA/ VO/RPA, 2 CSEA/VO, 1 CSEA/TSEA, 1 CSEA/ TSEA/LSEA), 13 had cervical osteomyelitis (VO: 11 VO/CSEA, 2 VO/RPA), and 12 had cervical retropharyngeal abscesses (RPA: 10 RPA/CSEA/VO, 2 RPA/VO alone). When patients were treated surgically, they required 12 anterior, and 2 posterior approaches; 1 patient required no surgery. In the 6 larger cervical series involving 355 patients, 4 series involved CSEA (3 CSEA, 1 CSEA/VO), and 2 seires had cervical VO. Primary surgery was performed in 298 patients, while 57 were initially managed medically; 24 of these latter patients failed non-surgical therapy, and required delayed cervical surgery. Notably, all 17 clinical studies advocated early surgery where clinically appropriate for varying combinations of CSEA and/or VO with or without RPA. The 8 final articles reviewed all-levels of SEA and or VO, while also providing additional unique information regarding RPA. We analyzed 11 case studies and 6 multiple case series regarding the diagnosis and treatment of combinations of cervical CSEA, and/or VO with or without RPA. We also reviewed 8 articles on the evaluation/ management of all-level SEAs and/or VOs, along with the unique features of RPAs.
Sections du résumé
BACKGROUND
BACKGROUND
Every year approximately 19.6 patients/100,000 per year are admitted to hospitals with spinal epidural abscesses (CSEA), 7.4/100,000 have vertebral osteomyelitis (VO)/100,000/year, while 4.1/100.000 children/year have cervical retropharyngeal abscesses (RPA) (i.e., data insufficient for adults).
METHODS
METHODS
Here we evaluated 11 individual case studies, 6 multiple patient series, and looked at 9 general review articles focusing on CSEA, and/or VO, with/without RPA.
RESULTS
RESULTS
Of the 11 case studies involving 15 patients, 14 had cervical spinal epidural abscesses (CSEA: 10 CSEA/ VO/RPA, 2 CSEA/VO, 1 CSEA/TSEA, 1 CSEA/ TSEA/LSEA), 13 had cervical osteomyelitis (VO: 11 VO/CSEA, 2 VO/RPA), and 12 had cervical retropharyngeal abscesses (RPA: 10 RPA/CSEA/VO, 2 RPA/VO alone). When patients were treated surgically, they required 12 anterior, and 2 posterior approaches; 1 patient required no surgery. In the 6 larger cervical series involving 355 patients, 4 series involved CSEA (3 CSEA, 1 CSEA/VO), and 2 seires had cervical VO. Primary surgery was performed in 298 patients, while 57 were initially managed medically; 24 of these latter patients failed non-surgical therapy, and required delayed cervical surgery. Notably, all 17 clinical studies advocated early surgery where clinically appropriate for varying combinations of CSEA and/or VO with or without RPA. The 8 final articles reviewed all-levels of SEA and or VO, while also providing additional unique information regarding RPA.
CONCLUSION
CONCLUSIONS
We analyzed 11 case studies and 6 multiple case series regarding the diagnosis and treatment of combinations of cervical CSEA, and/or VO with or without RPA. We also reviewed 8 articles on the evaluation/ management of all-level SEAs and/or VOs, along with the unique features of RPAs.
Identifiants
pubmed: 32637213
doi: 10.25259/SNI_294_2020
pii: SNI-11-160
pmc: PMC7332491
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
160Informations de copyright
Copyright: © 2020 Surgical Neurology International.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
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