Spinal Epidural Abscess (SEA), is occurring with greater frequency in our population but it is an often misdiagnosed cause of back pain that can result in serious consequences including paralysis if not detected and treated correctly. If SEA is diagnosed, surgery must be performed immediately to prevent these serious consequences.
A complete medical history regarding steroid use; IV drug use; recent spinal or paraspinal pain injections; dental infections; diabetes; and other risk factors should result in an MRI test if one or more risk factors are present. Unfortunately, this is not the protocol with many healthcare providers and we have seen patients with back pain sent home with pain killers only to return again, sometimes more than once, with the same complaints. Some, who should have been treated in a timely matter for SEA, are now paralyzed because the diagnosed was so delayed.
Although some of the symptoms of SEA may be absent, such as fever, numbness or weakness, lack of these symptoms does not rule out the SEA diagnosis as they may not occur until very late in the process. By then, it may be too late, to the serious detriment of the patient.
Back pain can be a symptom of a serious problem. A physician’s job is to sort out whether a patient’s back pain might be due to a serious underlying cause requiring urgent intervention. Getting a full medical history and conducting MRIs when risk factors are present should be the go-to protocol in every back-pain case to prevent severe neurological injury or even death.