What’s a spinal abscess?

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A spinal abscess is a cyst or pus-filled lesion that develops in the soft tissue surrounding the spinal cord. Most abscesses form in the lower or middle back as a result of infectious bacteria building up in the region. Many different types of bacteria can cause infections, and a spinal abscess can develop after pathogens enter a wound on the back or spread to the spine from another part of the body via the blood. Pain, swelling, fever, and chills are common, and more serious symptoms of paralysis and weakness can occur if an abscess compresses the spinal cord. Antibiotics and anti-inflammatory drugs can usually relieve symptoms, although a progressing abscess may need to be surgically drained.

Persistent strains of staph are the most common bacterial cause of a spinal abscess, although many other pathogens may be involved. Infection can enter the space around the spinal cord through a break in tissue from a traumatic injury or an unhealed surgical wound. Occasionally, bacteria makes its way to the spine from another site of infection such as the throat or lungs.

Early symptoms of a spinal abscess can include worsening back pain, tenderness and swelling in the spine, and flu-like symptoms of fever, chills, and fatigue. Some people also experience headaches, nausea and vomiting. If a cyst grows large enough to put pressure on the spinal cord, an individual may lose sensation and the ability for motor movement in the legs, arms, or other parts of the body. Without treatment, a spinal abscess can lead to severe paralysis.

A doctor can usually diagnose a spinal abscess by examining the symptoms and feeling the swollen section of back tissue. He or she may decide to have computed tomography scans and x-rays to confirm the existence of an abscess and rule out other problems such as tumors, bone deformities, and herniated discs. A sample of blood or cerebrospinal fluid can be collected and cultured in a laboratory to determine the type of bacteria causing the symptoms.

Treatment options can be discussed after the diagnosis is confirmed. Patients with relatively small abscesses and no symptoms of weakness or numbness can usually be treated on an outpatient basis with oral antibiotics. Mild pain and inflammation can be relieved with spinal corticosteroid injections. Most small abscesses and associated infections resolve in four to six weeks.

If spinal cord compression exists, a patient is typically admitted to the hospital and scheduled for immediate surgery. A specialist performs needle aspiration to drain pus from the spinal abscess and relieve spinal cord tension. Additional surgery is rarely needed to repair damaged tissue and realign the vertebrae. Recovery can take several weeks or months depending on the type of surgery received, but most patients eventually improve with no lasting movement problems.

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