MacNeille Rhett, Lay Johnson, Razzouk Jacob, Bogue Shelly, Harianja Gideon, Ouro-Rodrigues Evelyn, Ting Caleb, Ramos Omar, Veltman Jennifer, Danisa Olumide
Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, USA.
Department of Orthopaedics, School of Medicine, California University of Science and Medicine, Colton, USA.
Cureus. 2023 Feb 16;15(2):e35058. doi: 10.7759/cureus.35058. eCollection 2023 Feb.
Spinal epidural abscess (SEA) is a rare process with significant risk for morbidity and mortality. Treatment includes an extended course of antibiotics with or without surgery depending on the clinical presentation. Both non-operative and surgically treated patients require close follow-up to ensure the resolution of the infection without recurrence and/or progression of neurologic deficits. No previous study has looked specifically at follow-up in the SEA population, but the review of the literature does show evidence of varying degrees of difficulty with follow-up for this patient population.
This retrospective review looked at follow-up for 147 patients with SEA at a single institution from 2012 to 2021. Statistical analyses were performed to assess differences between groups of surgical versus non-surgical patients and those with adequate versus inadequate follow-up.
Sixty-two of 147 (42.2%) patients had inadequate follow-up (less than 90 days) with their surgical team, and 112 of 147 (76.2%) patients had inadequate follow-up (less than 90 days) with infectious disease (ID). The primary statistically significant difference between patients with adequate versus inadequate follow-up was found to be surgical status with those treated surgically more likely to have adequate follow-up than those treated non-operatively.
Improved follow-up in surgical patients should be considered as a factor when deciding on surgical versus non-operative treatment in the SEA patient population. Extra efforts coordinating follow-up care should be made for SEA patients.
脊柱硬膜外脓肿（SEA）是一种罕见的病症，具有较高的发病和死亡风险。治疗方法包括根据临床表现使用抗生素进行长期治疗，可选择手术或不进行手术。无论是非手术治疗还是手术治疗的患者都需要密切随访，以确保感染得到解决，且神经功能缺损不会复发和/或进展。此前尚无研究专门针对SEA患者群体的随访情况，但文献综述确实显示，该患者群体的随访存在不同程度的困难。
本回顾性研究观察了2012年至2021年在单一机构接受治疗的147例SEA患者的随访情况。进行了统计分析，以评估手术患者与非手术患者组之间以及随访充分与不充分的患者之间的差异。
147例患者中有62例（42.2%）对手术团队的随访不充分（少于90天），147例患者中有112例（76.2%）对传染病科（ID）的随访不充分（少于90天）。随访充分与不充分的患者之间在统计学上的主要显著差异在于手术状态，接受手术治疗的患者比非手术治疗的患者更有可能获得充分的随访。
在决定SEA患者群体的手术治疗与非手术治疗时，应将改善手术患者的随访情况作为一个考虑因素。应为SEA患者付出额外努力来协调随访护理。
