Spinal abscess is a rare disease - its incidence is so low that even more accurate incidence statistics are not available, but it can be recognized late as to whether it can be really dangerous if it is not treated properly. What are the causes and symptoms of such an abscess? How is a spinal abscess treated?
Spinal abscesscan occur at any age, but is most common in people between the ages of 20 and 30. The disease is more common in men. The symptoms of a spinal cord abscess are non-specific and therefore easily confused with symptoms of other neurological diseases, such as traumatic injury to the spinal cord, for example. It is very important to make a proper diagnosis - it results from the fact that draining the abscess and giving the patient the antibiotics he needs may lead to the resolution of the symptoms of the spinal cord abscess.
Spinal abscess: causes
In order for an abscess to form in the area of the spinal cord tissues, pathogenic bacteria must first enter this area of the body. Spinal cord abscess is most often caused by infections caused by bacteria of the genusStaphylococcus(staphylococci) and the genusStreptococcus(streptococci). Other bacteria, such as those of the generaActinomyces ,ProteusorPseudomonas , cause the disease less frequently. Bacteria, however, do not enter the structures of the spinal cord by themselves - it usually happens as a result of some other pathology, e.g.
- injuries around the spine and spine
- bacteremia (the appearance of pathogenic organisms in the blood)
- transmission of infection within the skin to the core tissues
- tuberculosis and its spread throughout the body
The formation of a spinal abscess can also be a complication of a variety of medical implications. Such a situation may take place when a patient undergoes a lumbar puncture, an abscess may also be a complication of some surgery - be it orthopedic or neurosurgical - performed on the spine.
Risk factors for a spinal abscess include:
- states of immunodeficiency (associated with, for example, the patient suffering fromAIDS, HIV infection or the use of immunosuppressive drugs)
- diabetes
- injecting drug use
Spinal abscess: symptoms
The ailments occurring in the course of a spinal cord abscess are not typical - they resemble problems that occur in various other spinal diseases (including those that occur after damage to this part of the nervous system). The symptoms of a spinal cord abscess can be:
- pain (usually with a sudden onset, it can be closely located in some part of the back, but also radiate to different parts of the body, e.g. to the upper or lower limbs)
- progressive muscle weakness
- sensory disturbances (they concern the area of the body that is below the location of the abscess)
- paralysis (similar to sensory disturbances, the muscles controlled by the structures of the spinal cord lying below the abscess are paralyzed; all four limbs and only the lower limbs may be paralyzed - it depends on the height of the spinal cord abscess)
- disorders in the conscious control of the bladder sphincter and anal sphincter (which may lead to urinary incontinence or faecal incontinence)
- male potency disorders
- signs of infection (such as fever or chills)
Abscesses are defined as sharply demarcated from the he althy tissues of the pus community. Oil is, in turn, a mixture of bacteria, cells of the immune system, and various remnants of various cells in the body. Abscesses can arise in a wide variety of locations, such as: lung abscesses, brain abscesses and spinal cord abscesses.
Spinal abscess: diagnosis
Symptoms of a spinal abscess are not specific. Coupled with the fact that it is a rare condition, it can be difficult to recognize. In a patient reporting the symptoms described above, a neurological examination is first carried out to help determine whether they have symptoms such as sensory disturbances, but also excessive tenderness of tissues around the spine. The medical history is also important, because if the doctor receives information that the patient, for example, has recently suffered a spinal injury or that he has had a lumbar puncture, it is possible that the physician will suspect that the cause of the patient's problems is an abscess of the spinal cord. To be sure, imaging tests (e.g. computed tomography or magnetic resonance imaging of the spinal cord) are required. Fromthe patient's blood may also be taken, in which the blood is marked, inter alia, white blood cell levels or inflammatory markers (such as CRP). In addition to the already mentioned tests, it is also necessary to conduct microbiological tests, because their results determine the subsequent therapeutic procedure.
Spinal abscess: treatment
In the treatment of spinal abscesses, surgical procedures and pharmacotherapy are used. Surgical treatment is aimed at accessing the abscess and then thoroughly cleaning the tissues. Precision is absolutely necessary here because if the abscess is not completely cleared, then there is a significantly increased risk of recurrence of the disease.
When it comes to pharmacological treatment, patients are given drugs from two different groups. The first are glucocorticosteroids, substances that reduce the swelling of the core associated with the development of an abscess. The second line of treatment consists of intravenous antibiotics. Initially, patients are treated with broad-spectrum antimicrobials (e.g. penicillins with beta-lactamase inhibitors). This treatment is later modified - but it does not happen until the results of microbiological tests are available. These determinations can be made, for example, by examining the contents obtained from the abscess. Identifying the specific pathogen that caused the spinal cord abscess is critical. It is during microbiological tests that it is possible to perform an antibiogram, i.e. to determine the sensitivity and resistance of bacteria to individual antibiotics. On its basis, patients are given such drugs to which the pathogen is most sensitive. Pharmacological treatment of a spinal abscess takes different amounts of time - some patients require antibiotics for up to several weeks.
Spinal abscess: prognosis
For patients with spinal abscess, the most important thing is to start treatment as soon as possible, because it reduces the risk that the abscess will lead to permanent neurological defects (such as permanent sensory disturbances, urinary incontinence or chronic pain). It is also important that the treatment of a spinal abscess is carried out for an appropriate time - if completed prematurely, it may end with a recurrence.
Patients who find themselves quickly under the care of medical specialists may have their symptoms subside after treatment. In some patients, despite the healing of the abscess, there are, unfortunately, various degrees of neurological deficits (in the form ofe.g. muscle strength disorders), which may disappear after the implementation of various interventions, such as e.g. rehabilitation.