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    Spinal Epidural Abscess: a Series of 101 Cases.
    Am J Med 2017 Aug 7. Epub 2017 Aug 7.
    Internal Medicine Department, Scripps Mercy Hospital, 4077 Fifth Ave, San Diego, CA 92103; Infectious Disease Division, Scripps Mercy Hospital, 4077 Fifth Ave, San Diego, CA 92103; Infectious Disease Division, Naval Medical Center San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134.
    Background: Spinal epidural abscesses are uncommon but potentially devastating infections that often elude early diagnosis. An increasing incidence has been suggested; however, few contemporary data are available regarding risk factors and epidemiologic trends over time.

    Methods: A retrospective study of spinal epidural abscesses from 2004 to 2014 at a large academic hospital was conducted. Read More

    A spinal infection with Staphylococcus pseudintermedius.
    BMJ Case Rep 2017 Aug 7;2017. Epub 2017 Aug 7.
    Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
    We present a case of a 60-year-old woman with an invasive spinal infection with Staphylococcus pseudintermedius associated with a 15-year-old spinal fixation device and epidemiological contact with dogs. It was confirmed on blood culture and culture from pus from the epidural abscess and successfully treated using similar treatment as for a Staphylococcus aureus infection - 6 weeks of intravenous flucloxacillin 2 g four times daily with a 6 week follow-on course of oral clindamycin 450 mg three times daily. This case represents the first reported deep abscess forming infection with this recently discovered organism. Read More

    The time-sensitive challenge of diagnosing spinal epidural abscess in the emergency department.
    Intern Emerg Med 2017 Aug 4. Epub 2017 Aug 4.
    Department of Emergency Medicine, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA.
    Spinal epidural abscess (SEA) is a rare but devastating condition. Entry of infectious contents into the epidural space occurs via contiguous infected tissue, hematogenous spread, or iatrogenic inoculation. Traditionally, emergency providers are taught to assess for the "classic triad" of spinal pain, fever, and neurological deficits, but this constellation of findings is seen in only 10-15% of cases. Read More

    The incidence, morbidity and surgical outcome of complex spinal inflammatory syndromes in adults.
    World Neurosurg 2017 Jul 27. Epub 2017 Jul 27.
    National Institute of Clinical Neurosciences, Budapest, Hungary; Department of Neurosurgery, Semmelweis University, Budapest, Hungary.
    Objective: Spondylodiscitis is a rare inflammatory syndrome affecting intervertebral discs and adjacent vertebral bodies. Without appropriate therapy, many serious complications such as secondary spinal epidural abscess (SEA) may prolong recovery time. The aim of the study is to compare the main characteristics of our patients to the international literature and to analyze the impact of complications associated with spondylodiscitis concerning clinical outcome. Read More

    Streptococcus intermedius: an unusual cause of spinal epidural abscess.
    J Spine Surg 2017 Jun;3(2):243-249
    The Spinal Column Biomechanics and Surgical Outcomes Laboratory, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
    Spinal epidural abscess (SEA) following dental procedures is a rarely reported entity. Here, we present a unique case of a 74-year-old immunocompetent man who developed severe lower back pain and bilateral lower extremity weakness 4 days following two root canal procedures. Lumbar spine magnetic resonance imaging (MRI) showed several pockets of epidural abscesses extending from L1 through L5. Read More

    Cerebral Epidural Abscess Secondary to Blastomyces Masquerading as an Epidermoid Tumor.
    Open Forum Infect Dis 2017 29;4(3):ofx112. Epub 2017 May 29.
    Departments of Neurosurgery, Pathology, and Medicine, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence.
    There have been infrequent reports of isolated central nervous system blastomycosis. We report a case of intracranial epidural abscess secondary to Blastomyces dermatitidis in a patient residing in Rhode Island with a history of remote travel to an endemic area. The clinical, radiographic, and pathologic features of this unique case are reviewed. Read More

    Spontaneous spinal epidural abscess in a normoglycemic diabetic patient - Keep it as a differential.
    J Clin Orthop Trauma 2017 Apr-Jun;8(2):178-180. Epub 2016 Sep 28.
    Department of Orthopaedics, Room No. 15, Nehru Hospital, PGIMER, Chandigarh 160012, India.
    Spinal epidural abscess (SEA) is a rare and serious condition which can lead to permanent neurological deficit. Spontaneous SEA is even rarer condition with an incidence of less than 1 per 10,000 person-year. Being spontaneous, it has high chances of being misdiagnosed, more so when the risk factors are not clearly explainable for the condition. Read More

    Primary calvarial tuberculosis.
    Surg Neurol Int 2017 21;8:126. Epub 2017 Jun 21.
    Department of Neurosurgery, Institute of Neurosurgery, Madras Medical College, Chennai, Tamil Nadu, India.
    Background: Tuberculosis is a very common disease in India. Its prevalence, capacity to affect every other organ, and atypical presentations make it an important part of the differential diagnosis for cases presenting in the rural setup. Primary tuberculous caries of the calvarium is a rare manifestation of this common entity. Read More

    Recent Developments in the Treatment of Spinal Epidural Abscesses.
    Orthop Rev (Pavia) 2017 Jun 23;9(2):7010. Epub 2017 Jun 23.
    Warren Alpert Medical School, Brown University, Providence, RI, USA.
    Spinal epidural abscess (SEA) is a serious condition that can be challenging to diagnose due to nonspecific symptomology and delayed presentation. Despite this, it requires prompt recognition and management in order to prevent permanent neurologic sequelae. Several recent studies have improved our understanding of SEA. Read More

    A novel case of Raoultella planticola osteomyelitis and epidural abscess.
    BMJ Case Rep 2017 Jul 13;2017. Epub 2017 Jul 13.
    Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
    A spinal epidural abscess is the collection of pus in the epidural space, and is a potentially life-threatening condition that requires early detection and prompt management. Almost two-thirds of cases are caused by Staphylococcus aureus, followed by Gram-negative bacilli which account for approximately 16% of cases. Raoultella planticola is an emerging pathogen, and is an extremely rare cause of invasive infection in humans. Read More

    Spinal angiolipomas: A puzzling case and review of a rare entity.
    J Craniovertebr Junction Spine 2017 Apr-Jun;8(2):91-96
    College of Medicine, Northeast Ohio Medical University, Rootstown, USA.
    Patients with spinal epidural abscesses (SEAs) may have a variable presentation. Such an infection has a typical appearance on magnetic resonance imaging (MRI) and enhances with gadolinium. We present a case that was a diagnostic challenge where pre- and intra-operative findings resulted in conflicting impressions. Read More

    Cervical spine epidural abscess: a single center analytical comparison to the literature.
    Spinal Cord Ser Cases 2017 6;3:17036. Epub 2017 Jul 6.
    Summa Health System, College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA.
    Study Design: Retrospective review of patient charts.

    Objectives: Cervical spine epidural abscess (CSEA) is uncommon. In this study, characteristics of CSEA patients are described through an institutional analysis and literature review. Read More

    Emergency 1-stage anterior approach for cervical spine infection complicated by epidural abscess.
    Medicine (Baltimore) 2017 Jun;96(26):e7301
    Department of Spine Surgery, Shanghai East Hospital, Tongji University, Shanghai, China.
    It was a retrospective analysis.The aim of the study was to explore the safety and reliability of emergency 1-stage radical debridement and reconstruction using titanium mesh filled with autologous bone for patients with cervical spine infection complicated by epidural abscess.At present, cervical spine infection complicated by epidural abscess is known as a severe spine disease. Read More

    Oesophageal pleural fistula presenting with Parvimonas micra infection causing cervical and brain abscesses.
    Anaerobe 2017 Jun 23;47:233-237. Epub 2017 Jun 23.
    Academic Neurosurgery Unit, St George's University of London, London, UK.
    Parvimonas micra (P. micra) infections causing spinal cord compression are extremely rare. We report an occult oesophageal pleural fistula presenting with spinal epidural and brain abscesses resulting in severe neurological deficits caused by P. Read More

    Disco vertebral osteomyelitis causing intradural spinal abscess with cauda equina compression.
    Br J Neurosurg 2017 Mar 3:1-3. Epub 2017 Mar 3.
    a Academic Neurosurgery Unit, Atkinson Morley Neurosurgery Centre , St George's, University of London , London , UK.
    Intradural extramedullary spinal infections causing cauda equina compression are uncommon. We report an Escherichia coli bacteraemia causing lumbar discitis and an intracanalicular collection compressing the cauda equina: initially thought to be an epidural empyema, however microsurgery revealed an intradural location. Decompression, drainage, antibiotics, and neuropathy treatment are essential management. Read More

    Minimally invasive spine surgery in lumbar spondylodiscitis: a retrospective single-center analysis of 67 cases.
    Eur Spine J 2017 Jun 12. Epub 2017 Jun 12.
    Department of Neurosurgery, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
    Background: Minimally invasive surgical techniques have been developed to minimize tissue damage, reduce narcotic requirements, decrease blood loss, and, therefore, potentially avoid prolonged immobilization. Thus, the purpose of the present retrospective study was to assess the safety and efficacy of a minimally invasive posterior approach with transforaminal lumbar interbody debridement and fusion plus pedicle screw fixation in lumbar spondylodiscitis in comparison to an open surgical approach. Furthermore, treatment decisions based on the patient´s preoperative condition were analyzed. Read More

    [Spondylodiscitis : Current strategies for diagnosis and treatment].
    Orthopade 2017 Jun 6. Epub 2017 Jun 6.
    Klinik für Orthopädie und Unfallchirurgie, Universität Duisburg-Essen, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
    Spondylodiscitis is a severe infectious disease of the intervertebral discs and of the adjacent parts of the vertebral bodies, culminating in destruction of the mobile segment. It is accompanied by a mortality rate of approximately 15%. Severe courses of the disease can also lead to abscess formation and dispersal of sepsis. Read More

    Magnetic resonance imaging of bacterial and tuberculous spondylodiscitis with associated complications and non-infectious spinal pathology mimicking infections: a pictorial review.
    BMC Musculoskelet Disord 2017 Jun 5;18(1):244. Epub 2017 Jun 5.
    Department of Radiology, Yale New Haven Health System at Bridgeport Hospital, 267 Grant Street, Bridgeport, 06610, CT, USA.
    Magnetic resonance (MR) imaging plays an important role in the evaluation of bacterial and tuberculous spondylodiscitis and associated complications. Owing to its high sensitivity and specificity, it is a powerful diagnostic tool in the early diagnosis of ongoing infections, and thus provides help in prompt initiation of appropriate, therapy which may be medical or surgical, by defining the extent of involvement and detection of complications such as epidural and paraspinal abscesses. More specifically, MR imaging helps in differentiating bacterial from tuberculous infections and enables follow up of progression or resolution after appropriate treatment. Read More

    Characteristics of and risk factors for severe neurological deficit in patients with pyogenic vertebral osteomyelitis: A case-control study.
    Medicine (Baltimore) 2017 May;96(21):e6387
    aDepartment of Infectious Diseases, University Hospital of Tours, Francois Rabelais University, Tours bClinical Research Unit, University Hospital A. Paré, APHP, Boulogne cInfectious Diseases Unit, University Hospital R. Poincaré, APHP, Versailles Saint Quentin University, Garches dDepartment of Internal Medicine, University Hospital Beaujon, APHP, Clichy eRadiology Department, Neuro-musculoskeletal Pole, University Hospital R Poincaré, APHP, Versailles University, Paris-Saclay UMR 1179, Garches fDepartment of Neurosurgery University Hospital of Tours, Tours gDepartment of Infectious Diseases, University Hospital of Limoges, Limoges hDepartment of Infectious Diseases, Mignot Hospital, Versailles iDepartment of Infectious Diseases, Bichat-Claude Bernard University Hospital, APHP, Paris jDepartment of Infectious Diseases, Hotel-Dieu University Hospital, Nantes kInfectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes lDepartment of Infectious Diseases, Clinique du Parc, Lyon mDepartment of Neuroradiology, University Hospital of Tours, Francois Rabelais University, Tours, France.
    Severe neurological deficit (SND) is a rare but major complication of pyogenic vertebral osteomyelitis (PVO). We aimed to determine the risk factors and the variables associated with clinical improvement for SND during PVO.This case-control study included patients without PVO-associated SND enrolled in a prospective randomized antibiotic duration study, and patients with PVO-associated SND managed in 8 French referral centers. Read More

    [Rare medico-surgical emergency: spinal epidural abscess (about 3 cases)].
    Pan Afr Med J 2017 14;26:145. Epub 2017 Mar 14.
    Service Neurochirurgie, CHU Hassan II, Fès, Maroc.
    The awareness about infections in the epidural space is increasing thanks to the development of neurosurgery, including MRI. Spinal epidural abscess is a rare pathology but extremely serious from a functional point of view and potentially life threatening. We report three cases of male patients (the first one aged 52 years, the second 57 years and the third 63 years) with diagnosed spinal epidural abscess. Read More

    Patient presenting with frontal subperiosteal abscess and headache: a case of Pott's puffy tumour.
    Br J Neurosurg 2017 May 22:1-3. Epub 2017 May 22.
    a Department of Neurosurgery , Gülhane Military Medical Academy, Haydarpaşa Teaching Hospital , Istanbul , Turkey.
    Chronic sinusitis can be complicated with erosion of anterior or posterior wall of the sinus; causing Pott's puffy tumour in the anterior, or epidural abscess in the posterior communication. A 65-year old man with a painful swelling in his forehead is presented. Pott's puffy tumour was diagnosed. Read More

    Pseudogout of the cervical and thoracic spine mimicking infection after lumbar fusion: case report.
    J Neurosurg Spine 2017 Aug 19;27(2):145-149. Epub 2017 May 19.
    Department of Neurological Surgery, and.
    Pseudogout is a form of acute calcium pyrophosphate deposition (CPPD) disease that typically afflicts the elderly. CPPD commonly involves larger joints, such as the knees, wrists, shoulders, and hips, and has been known to involve the spine. The authors report the case of a 66-year-old woman with a recent history of lumbar laminectomy and fusion who presented 5 weeks postprocedure with a clinical and radiographic picture consistent with multilevel skip lesions involving the cervical and thoracic spine, thoracic discitis, and epidural abscess. Read More

    [Pediatric case report: Spinal epidural abscess].
    Arch Argent Pediatr 2017 06;115(3):e146-e149
    Hospital Interzonal Especializado Materno Infantil "Don Victorio Tetamanti", Mar del Plata.
    Spinal epidural abscess is an uncommon pathology. It has an incidence of one case per 100 000 individuals. An increase is observed due to the raise of risk factors such as diabetes mellitus, spinal abnormalities, tattoos, acupuncture, epidural analgesia, and a greater availability of imaging methods. Read More

    Assessment of malpractice claims due to spinal epidural abscess.
    J Neurosurg Spine 2017 May 12:1-8. Epub 2017 May 12.
    Division of Spine Surgery, Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
    OBJECTIVE Spinal epidural abscesses (SEAs) can be difficult to diagnose and may result in neurological compromise or even death. Delays in diagnosis or treatment may worsen the prognosis. While SEA presents a high risk for litigation, little is known about the medicolegal ramifications of this condition. Read More

    Diskitis, Osteomyelitis, Spinal Epidural Abscess, Meningitis, and Endocarditis Following Sacroiliac Joint Injection for the Treatment of Low-Back Pain in a Patient on Therapy for Hepatitis C Virus.
    Reg Anesth Pain Med 2017 Jul/Aug;42(4):517-520
    From the *Department of Anesthesiology and †Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
    Objective: Sacroiliac joint injections are frequently performed procedures in the management of acute and chronic low-back pain, including patients with various immunocompromised states. Infectious complications following these procedures along with other spinal injections are rarely reported, but the true incidence is unknown. The purpose of this report is to highlight the devastating neurologic sequela that can occur, and to discuss potential future management strategies. Read More

    Spinal subdural abscess following repeat lumbar microdiscectomy: A case report of imaging findings for a rare infection.
    Clin Imaging 2017 Jul - Aug;44:74-78. Epub 2017 Apr 27.
    University of Virginia, Department of Radiology and Medical Imaging, United States. Electronic address:
    Spinal subdural abscess is a rare central nervous system infection with just over a hundred cases reported. It is much less common than spinal epidural abscess. While most case reports have focused on route of infection and treatment options, there have not been any reports that focused on the unique MRI findings of spinal subdural abscess. Read More

    Cervical Spondylodiscitis: Presentation, Timing, and Surgical Management in 59 Patients.
    World Neurosurg 2017 Jul 27;103:664-670. Epub 2017 Apr 27.
    Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
    Background: Cervical spondylodiscitis is thought to carry a significant risk for rapid neurologic deterioration with a poor response to nonsurgical management.

    Methods: A retrospective surgical case series of the acute surgical management of cervical spondylodiscitis is reviewed to characterize the neurologic presentation and postoperative neurologic course in a relatively uncommon disease.

    Results: Fifty-nine patients were identified (mean age, 59 years [range, 18-83 years; SD ± 13. Read More

    A Pott's Puffy Tumor Associated with Epidural - Cutaneous Fistula and Epidural Abscess: Case Report.
    Balkan Med J 2017 May 13;34(3):284-287. Epub 2017 Apr 13.
    Department of Neurosurgery, Military Medical Academy School of Medicine, Belgrade, Serbia.
    Background: Pott's puffy tumour is characterized by a fluctuate swelling of the frontal region as a result of osteomyelitis of the frontal bone. This inflammatory lesion may propagate endocranially, resulting in acute meningitis, epidural abscess, subdural empyema, cavernous sinus trombophlebitis, cerebritis, and frontal lobe abscess of the brain.

    Case Report: We present an unusual case of a 33-year-old man suffering from Pott's puffy tumour whose condition was further complicated by a draining epidural-cutaneous fistula and an epidural abscess. Read More

    Diagnosis of spinal epidural abscess: a case report and literature review.
    Spinal Cord Ser Cases 2017 6;3:17013. Epub 2017 Apr 6.
    Department of Emergency Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA.
    Introduction: Spinal epidural abscess (SEA) is a rare but serious cause of back pain in the critical care setting. It occurs most commonly in adults in their fifth and sixth decades of life. Risk factors include diabetes mellitus, alcoholism, AIDS or other immunocompromised states, cancer, intravenous drug use, trauma and spinal surgery. Read More

    A spinal epidural abscess due to Streptobacillus moniliformis infection following a rat bite: case report.
    J Neurosurg Spine 2017 Jul 21;27(1):92-96. Epub 2017 Apr 21.
    Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Friederich-Alexander-Universität Erlangen-Nürnberg, Universitätsklinikum Erlangen, Erlangen, Germany ; and.
    The authors describe the case of a 40-year-old man suffering from an epidural abscess in the thoracic spine due to a rarely isolated pathogen, Streptobacillus moniliformis, the causative agent of rat bite fever. Besides diffuse abdominal pain, ataxia, paresthesia, hypesthesia, and enhanced reflexes of the lower extremities, the patient suffered from a decreased sensation of bladder filling. His history was also positive for a rat bite 6 weeks earlier. Read More

    Spinal epidural abscess caused by Brucella species: a review of 17 cases.
    J Neurosurg Sci 2017 Jun;61(3):271-276
    Department of Orthopedics, First Affiliated Hospital of Soochow University, Soochow, China.
    Background: Spinal epidural abscess (SEA) is a rarely encountered clinical entity during the course of Brucella infection.

    Methods: We reported 17 patients diagnosed with Brucellar SEA for a mean follow-up of 15 months. Spinal epidural abscess was detected by magnetic resonance imaging in all cases. Read More

    Melanized fungus as an Epidural abscess: A diagnostic and therapeutic challenge.
    Med Mycol Case Rep 2017 Jun 6;16:20-24. Epub 2017 Apr 6.
    Department of Microbiology, AIIMS Bhopal, Bhopal 462024, MP, India.
    Curvularia a dematiaceous fungus is ubiquitously found in soil around the world. We report an epidural abscess due to Curvularia lunata in a 48 years male farmer who underwent decompressive laminectomy as primary modality of treatment followed by isolation, identification and confirmation of the isolate from tissue by ITS sequencing. Antifungal therapy with voriconazole and amphotericin B for 3 and 2 weeks respectively improved patient's condition and is presently on regular follow up with no sequelae since last 7 months. Read More

    Destruction of the C2 Body due to Cervical Actinomycosis: Connection between Spinal Epidural Abscess and Retropharyngeal Abscess.
    Korean J Spine 2017 Mar 31;14(1):20-22. Epub 2017 Mar 31.
    Department of Neurosurgery, Chosun University College of Medicine, Gwangju, Korea.
    Human actinomycosis with involvement of the spine is a rare condition, with only a limited number of case reports published. To the best of our knowledge, no cases have been reported of epidural abscess causing destruction of the C2 body, bringing about a direct connection between spinal epidural and retropharyngeal abscesses. Here, we present such a case that occurred after acupuncture, and we review the relevant literature. Read More

    Gas-Containing Cervical Epidural Abscess Accompanying Bacterial Meningitis in an Adult.
    Korean J Spine 2017 Mar 31;14(1):17-19. Epub 2017 Mar 31.
    Department of Neurosurgery, Chosun University College of Medicine, Gwangju, Korea.
    Gas-containing spinal epidural abscesses are uncommon. Moreover, acute spinal epidural abscesses rarely complicate bacterial meningitis in adults. Here, we report a rare case of a gas-containing cervical epidural abscess accompanying bacterial meningitis. Read More

    Pott puffy tumor.
    Proc (Bayl Univ Med Cent) 2017 Apr;30(2):179-181
    Department of Radiology, Yale New Haven Health at Bridgeport Hospital, Bridgeport, Connecticut (P. Sharma, S. Sharma, Kochar, Kumar); and the Department of Radiology, St. Vincent's Medical Center, Bridgeport, Connecticut (Gupta).
    Pott puffy tumor is osteomyelitis of the frontal bone with associated subperiosteal abscess causing swelling and edema over the forehead and scalp. It is a complication of frontal sinusitis or trauma. We present the case of an 8-year-old girl with frontal swelling. Read More

    Discography aids definitive diagnosis of posterior epidural migration of lumbar disc fragments: case report and literature review.
    BMC Musculoskelet Disord 2017 Apr 11;18(1):151. Epub 2017 Apr 11.
    Department of Orthopaedic Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa, 220-8521, Japan.
    Background: Posterior epidural migration of lumbar disc fragments (PEMLDF) is extremely rare. It is often confused with other posterior lesions and is usually diagnosed intraoperatively. We here describe the use of preoperative discography in the diagnosis of PEMLDF. Read More

    Staphylococcus aureus Central Nervous System Infections in Children.
    Pediatr Infect Dis J 2017 Apr 10. Epub 2017 Apr 10.
    Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine and Texas Children's Hospital, Houston, TX.
    Background: Central nervous system (CNS) infections due to Staphylococcus aureus are uncommon in pediatric patients. We review the epidemiology, clinical features, and treatment in 68 patients with a S. aureus CNS infection evaluated at Texas Children's Hospital (TCH). Read More

    Paraspinal Edema Is the Most Sensitive Feature of Lumbar Spinal Epidural Abscess on Unenhanced MRI.
    AJR Am J Roentgenol 2017 Jul 5;209(1):176-181. Epub 2017 Apr 5.
    5 Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Ste BG20, Atlanta, GA 30322.
    Objective: Spinal epidural abscess (SEA) is a serious infection requiring prompt treatment and potential neurosurgical intervention. Although contrast-enhanced spine MRI is the mainstay for diagnosis of SEA, unenhanced MRI is typically performed for patients with nonspecific symptoms or insufficient clinical information. We evaluated the sensitivity and specificity of imaging features suggestive of SEA at unenhanced spine MRI. Read More

    Errors in Diagnosis of Spinal Epidural Abscesses in the Era of Electronic Health Records.
    Am J Med 2017 Aug 31;130(8):975-981. Epub 2017 Mar 31.
    Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Tex; Department of Medicine, Baylor College of Medicine, Houston, Tex. Electronic address:
    Purpose: With this study, we set out to identify missed opportunities in diagnosis of spinal epidural abscesses to outline areas for process improvement.

    Methods: Using a large national clinical data repository, we identified all patients with a new diagnosis of spinal epidural abscess in the Department of Veterans Affairs (VA) during 2013. Two physicians independently conducted retrospective chart reviews on 250 randomly selected patients and evaluated their records for red flags (eg, unexplained weight loss, neurological deficits, and fever) 90 days prior to diagnosis. Read More

    Frontal Sinus Breach During Routine Frontal Craniotomy Significantly Increases Risk of Surgical Site Infection: 10-Year Retrospective Analysis.
    Neurosurgery 2017 Mar 10. Epub 2017 Mar 10.
    Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan.
    Background: Frontotemporal craniotomies are commonly performed for a variety of neurosurgical pathologies. Infections related to craniotomies cause significant morbidity. We hypothesized that the risk of cranial surgical site infections (SSIs) may be increased in patients whose frontal sinuses are breached during craniotomy. Read More

    A Contemporary Medicolegal Analysis of Implanted Devices for Chronic Pain Management.
    Anesth Analg 2017 Apr;124(4):1304-1310
    From the *Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; and †CRICO Strategies, Boston, Massachusetts.
    Background: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. Read More

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