Spinal epidural abscess epidemiology

The incidence of spinal epidural abscess (SEA) has doubled in the past decade, owing to an aging population and to increased use of spinal instrumentation and vascular access.

Incidence: 0.2–1.2 per 10,000 hospital admissions annually 1). possibly on the rise 2) Average age: 57.5 ± 16.6 years 3). Thoracic level is the most common site (≈ 50%), followed by lumbar (35%) then cervical 82% were posterior to the cord, and 18% anterior in one series 4). SEA may span from 1 to 13 levels 5).

Spinal epidural abscess (SEA) is often associated with vertebral osteomyelitis (in one series of 40 cases, osteomyelitis occurred in all cases of anterior SEA, in 85% of circumferential SEA, and no cases of posterior SEA) and intervertebral discitis.

1) , 4)
Baker AS, Ojemann RG, Swartz MN, et al. Spinal Epidural Abscess. N Engl J Med. 1975; 293:463– 468
2)
Nussbaum ES, Rigamonti D, Standiford H, et al. Spinal Epidural Abscess: A Report of 40 Cases and Review. Surg Neurol. 1992; 38:225–231
3)
Danner RL, Hartman BJ. Update of Spinal Epidural Abscess: 35 Cases and Review of the Literature. Rev In fect Dis. 1987; 9:265–274
5)
Curry WT, Jr, Hoh BL, Amin-Hanjani S, Eskandar EN. Spinal epidural abscess: clinical presentation, management, and outcome. Surg Neurol. 2005; 63:364–71; discussion 371