[Spinal epidural abscess--report of 5 cases].

We reported 5 patients with spinal epidural abscess. They were two men and three women. Their ages ranged from 48 to 56 years (mean, 53 years). In three out of 5 cases, the etiology was thought to be infection after lumbar discography, tracheostomy and lumber surgery. In the other two cases the etiology could not be determined. The abscess was located at cervical, thoracic and lumbar levels in 2, 1 and 2 cases, respectively. The interval between initial symptoms and operation was from 1 to 3 months. Purulent epidural collection was found in four cases at operation. Irrigation and drainage were sufficiently performed postoperatively in 4 cases. Antibiotic therapy had been continued for at least 8 weeks in every case. As demonstrated in the case 2, CT scan was very useful in determining the extension of the abscess and degree of the cord compression by the abscess. Also in the case 2, the epidural abscess extending from cervical canal to extracanalicular space was completely drained by applying draining tubes without laminectomy. The present results indicate that emergency laminectomy is not always necessary for the treatment of epidural abscess, especially in subacute or chronic cases.