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J Neurol Surg A Cent Eur Neurosurg 2023; 84(01): 77-90
DOI: 10.1055/s-0041-1739210
Case Report

Surgical Outcome of Spinal Subdural Abscesses: A Report of Four Consecutive Patients and Brief Review of the Literature

Anas Abdallah 
1   Department of Neurosurgery, Aile Hospital, Istanbul, Turkey
,
Erhan Emel 
2   Department of Neurosurgery, University of Health Sciences, Bakırköy Research and Training Hospital for Neurology Neurosurgery, and Psychiatry, Istanbul, Turkey
,
Betül Güler Abdallah 
3   Department of Psychiatry - AMATEM Unit, University of Health Sciences, Bakırköy Research and Training Hospital for Neurology Neurosurgery, and Psychiatry, Istanbul, Turkey
,
Delal Öztürk 
4   Department of Physical Therapy and Rehabilitation, Bezmialem Vakif University, Istanbul, Turkey
,
İrfan Çınar 
1   Department of Neurosurgery, Aile Hospital, Istanbul, Turkey
,
Rashid Avyasov 
1   Department of Neurosurgery, Aile Hospital, Istanbul, Turkey
› Author Affiliations Funding None.
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Abstract

Background and Study Aims Spinal subdural abscesses (SSAs) are rare and have a poor prognosis, especially when they are diagnosed late. In the literature, most cases of SSAs have been reported as case reports and small case series. In this study, we aimed to evaluate the surgical outcomes of four consecutive SSA patients.

Material and Methods In this retrospective study, we reviewed the medical charts of four SSA patients who underwent surgical intervention at two neurosurgical centers from September 2012 to September 2019.

Results Our series comprised four patients (three females and one male) with SSA (intradural–extramedullary) who were treated surgically. Holocord SSA was observed in two patients. The mean age was 15.1 ± 17.1 years. Unsteady gait and weakness of legs was the presenting symptom in all patients. The mean preoperative course was 5.3 ± 3.4 weeks. The causative pathogens were methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli, and Mycobacterium tuberculosis. In the fourth case, the pathogen was non–M. tuberculosis. In the 44th postoperative month, the patient underwent surgery for an intramedullary abscess. The causative pathogen was E. coli. Except for one adolescent male who was paraplegic at presentation, improvement was observed in all patients at their last follow-up after 54.0 ± 35.9 months after surgery.

Conclusion Early diagnosis and urgent surgical intervention are essential for a good prognosis in SSA cases. We recommend drainage followed by appropriate antibiotics.

Keywords

spinal subdural abscess - holocord abscess - emergent surgical intervention - antibiotic - physical therapy and rehabilitation

Note

This retrospective study was approved under decision number 532/2015 by the medical ethics committee of Bakırköy Research and Training Hospital for Neurology Neurosurgery, and Psychiatry (BRSHH), University of Health Sciences in Istanbul, Turkey.


Statement of Authorship

AA was responsible for conceptualization, methodology, software, supervision, formal analysis, literature review, visualization, investigation, writing the original draft, and review of the manuscript. EE, BGA, İÇ, and RA were responsible for validation. EE was also responsible for supervision and writing and review of the manuscript. Writing, reviewing, editing, literature review, and formal analysis were done by BGA. DÖ also participated in the literature review. İÇ was involved in validation, supervision, writing, and reviewing of the manuscript.




Publication History

Received: 23 January 2021

Accepted: 23 April 2021

Article published online:
18 January 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
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