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
