Spinal cord abscess is an infection in and around the spinal cord characterized by formation of pus. Generally spinal cord abscess is caused due to bacterial infection. The common organism involved is staphylococcus species. In some cases the abscess can also develop due to infection with tubercular bacilli. Spinal cord abscess is not common illness and it mainly occurs when the immunity of an individual is very low. It mainly occurs among people using intravenous drugs, HIV patients, diabetics etc.
The disease manifests itself with slow onset of back pain which gradually increases over a period of time.
Spinal cord abscess can be diagnosed with the help of MRI scan, blood tests etc. The main line of treatment is use of antibiotics and surgical drainage of the abscess if necessary. Complication includes compression of spinal cord which may cause permanent paralysis.
Possible Causes Of Spinal Cord Abscess
Spinal cord abscess is caused by bacterial infection. In majority of cases the causative organism is staphylococcus or streptococcus bacteria.
Following are the possible causes:
- Infection somewhere else in the body such as in urinary bladder, respiratory tract, infection in ear. Bacteria can spread through the blood.
- Infection in adjacent tissue, for example psoas abscess, infection in bones.
- Infection can spread through invasive procedures due to contamination. Example is spinal anesthesia, introduction of steroid in epidural space through injection, use of epidural catheter after surgery to reduce pain etc.
- Use of intravenous drugs.
- Person with immune-compromised state as in case of HIV patients, diabetes, etc.
- Boils on skin or scalp. The infection can spread to the spinal cord if patient’s immune system is low.
- Spinal tuberculosis can result in abscess formation. The germs can spread from lungs into the spinal cord.
Signs And Symptoms Of Spinal Cord Abscess
The onset of symptoms may be gradual. In the beginning they may be generalized and it may become difficult to suspect spinal cord abscess. However, over a period of time they become more prominent. The symptoms include:
- Mild to moderate pain in back. Gradually pain becomes severe and patient experiences pain with any movement.
- Pain radiating to leg or arm or around the lower chest.
- Fever with chills.
- Muscle weakness in leg and upper extremities.
- Loss of bladder control and stool control if the spinal cord is compressed and the nerves are damaged.
- Paralysis of lower legs or upper extremity depending on the area where abscess has developed in or around the spinal cord.
Diagnosis And Treatment Of Spinal Cord Abscess
The medical practitioner is able to diagnose spinal cord abscess with following:
- Proper medical history and clinical examination.
- During examination, the doctor may lookout for tenderness over the spinal area.
- Decreased sensation in lower leg.
- Loss of power in extremities.
- X-ray of spine
- MRI spine
- Blood test
Once spinal cord abscess is diagnosed, the treatment of choice is broad spectrum antibiotics. Patient may also need anti inflammatory and pain killer medicines to relieve pain. Usually antibiotic medicines are given intravenously as it reaches the area of infection properly. Early detection and treatment with antibiotics is important to prevent neurological complications such as paralysis.
Secondly as the patient’s condition stabilizes, the doctor may drain the abscess through surgery. The main goal is to relieve pressure of collected pus on the spinal cord and kill the organisms. If the condition is not treated it can lead to compression of the spinal cord and subsequent paralysis which is permanent.