Patient selection: spinal epidural abscess
Contraindications to surgical management:
(1) The patient refuses to have surgery.
(2) The patient is a high risk for operative morbidity and mortality.
(3) The patient has been paralyzed for > 24 hours.
(4) There is paraspinal infection.
If there are no contraindications to surgical management then the patient should:
(1) undergo emergency decompressive laminectomy
(2) receive antibiotic therapy guided by susceptibility studies on culture isolates
If there are contraindications to surgery then treat with antibiotics based on susceptibility studies:
(1) based on blood cultures
(2) based on culture of CT-guided needle aspirates of the abscess
