What is a spinal cord
A spinal cord abscess (SCA) is a rare condition than can
cause permanent damage to your spinal cord. An abscess is a swollen area in
your tissues that contains a buildup of pus. It happens when injured tissues
becomes infected. Your body’s immune system sends white blood cells to help
fight off infection. The white blood cells begin to fill the damaged tissue,
causing pus to build up. Pus is made up of dead cells, immune cells, and
Since antibiotics have become widespread, SCAs have become
extremely rare. If you develop one, your doctor will likely use surgery and
antibiotics to treat it. They may also recommend rehabilitative therapy to help
you recover from neurological symptoms.
What are the
symptoms of a spinal cord abscess?
At first, an SCA may produce no symptoms. But as the infection
or abscess grows, it can put pressure on your spinal cord. The infection and
pressure can cause potentially serious symptoms, such as:
- sudden onset of pain
- sharp pain that can radiate to your arms or legs
- weakness that progresses rapidly
- loss of sensation below the area of the abscess
- paralysis below the area of the abscess
- loss of control of your bladder and bowels
What causes a spinal
A SCA is usually caused by the introduction of bacteria into
your spinal cord. The most common bacteria that cause SCAs come from the Staphylococcus
and Streptococcus species. Once these bacteria are inside your body,
they may find a place to live and grow in your spinal cord. Your body sends
white blood cells to fight the bacterial infection, causing pus to build up and
an abscess to form.
Other possible causes of an SCA include:
- boils that develop on your skin, especially on
the skin of your back or scalp
- septicemia, an infection
of your blood that can spread to your central nervous system
- injury caused by a foreign object, such as a
bullet or knife
- complications from back surgery or a lumbar
- dermal sinus, a channel that can form between
your skin and spinal canal while you’re developing in utero
What are the risk factors for developing a spinal cord abscess?
You’re at higher risk of developing an SCA if you have:
- a history of using anticoagulant agents, or
blood thinners, on a long-term basis
- a weakened immune system, which makes it easier for
bacterial infections to develop
- Crohn’s disease, a disease that can
cause lesions to form and burst in your digestive tract
- a ruptured gallbladder
- a habit of injecting illicit drugs
is a spinal cord abscess diagnosed?
The symptoms of an SCA are often vague and may be similar to
those of other conditions. As a result, it may be challenging for your doctor
to diagnose an SCA. They may use multiple diagnostic tests and tools, including
blood tests, imaging tests, and a lumbar puncture.
Your doctor may start by drawing a sample of your blood for
testing in a laboratory. Technicians will check your blood for signs of
infection. For example, they may assess your:
- complete blood count (CBC)
- erythrocyte sedimentation rate (ESR)
- C-reactive protein levels
Your doctor may also collect a sample of your cerebrospinal
fluid (CSF) for analysis. CSF is a clear, watery fluid that surrounds your
spine and brain. It helps to cushion and protect them.
To collect a sample of your CSF, your doctor will perform a
lumbar puncture, also known as a spinal tap. They will insert a needle into
your spinal cavity to collect a sample of the fluid. Then they will send it to
a laboratory, where technicians will check it for signs of infection.
Your doctor may also use imaging technologies to examine
your spine. For example, they may order:
- computed tomography (CT) scan
- magnetic resonance imaging (MRI)
How is a spinal cord
Early diagnosis and treatment is essential. If left untreated,
an SCA can burst, allowing millions of bacteria spread throughout your body.
Once your doctor has located an SCA, they will have to drain
or remove the abscess. For example, they may refer you to a surgeon for a
laminectomy. For this procedure, you will be placed under anesthesia. Then your
surgeon will open the abscess carefully and drain all of the pus and fluid
inside. They’ll rinse it with sterile saline fluid to wash away remaining
bacteria. If they find a dermal sinus, they will typically excise the sinus.
Your doctor will likely prescribe antibiotics too. These
drugs will help kill disease-causing bacteria in your system and prevent the
risk of further infection.
What are the
potential complications of a spinal cord abscess?
The dangerous potential complications of an SCA are recurrent
infection, persistent pain, weakness, numbness, loss of bowel or bladder
control, and even death.
It can also cause neurological symptoms and complications
that persist for weeks or even years after your abscess is drained or removed.
You may need neurorehabilitation to treat these symptoms.
Other complications can include dysuria and stress
incontinence. Dysuria refers to difficult or painful urination. If you have
stress incontinence, it’s hard to control your bladder under physical stress,
such as when you’re laughing.
is the outlook for someone with a spinal cord abscess?
The earlier you get an SCA treated, the more positive your outlook.
If left untreated, it can lead to more widespread infections. Early and
effective treatment can help prevent the infection from getting worse and
spreading. It can also help relieve your symptoms. If you have neurological
symptoms that persist after your initial treatment, you may need rehabilitative
therapy. It can help you regain your ability to move and function normally.
Ask your doctor for more information about your specific
condition, treatment plan, and outlook.