Pediatric Cervical Epidural Abscess

Abstract

Objective: Since spinal epidural abscess (SEA) may demonstrate nonspecific symptoms, delay in the diagnosis may cause severe neuronal damage. Evacuation of the abscess together with antibiotic therapy is mandatory. Dependent on the number of spinal levels affected stabilization may be necessary.

Material and Methods: A 7-year-old boy who had been suffering from neck pain for 2 months was hospitalized in our clinic with the complaints of restriction in neck movements and weakness in the right arm. On neurological examination, a paresis of 2/5 in the right upper extremity and hypoaesthesia between C2, and C7 were detected. There was spasm and restricted movements in the neck. Cervical Magnetic Resonance Imaging (MRI) revealed an epidural abscess, extending from C1 to C7. The patient underwent urgent surgery, C1-C2 complete laminectomy, C3-C4 right hemilaminectomy were performed, the abscess was drained, and occipitocervical stabilization was realized.

Results: Microbial growth was not detected on culture. The patient’s neurological deficits were completely cured on the 5. postoperative day. The patient was administered antibiotherapy for 4 weeks postoperatively. No recurrence was observed on cervical MRI at the 3rd month control visits.

Conclusion: Spinal epidural abscesses must be diagnosed in the early period and evacuated surgically as they may lead to permanent neurological deficits and even death in case of delay in the diagnosis, and treatment.