A spinal cord abscess is caused when infection occurs within the internal areas of the spine. An abscess of the spinal cord itself is very, very rare. A spinal abscess usually occurs as an epidural abscess.

Pus forms as a collection of fluid, destroyed tissue cells, white blood cells, and live and dead microorganisms. The pus commonly becomes encapsulated (enclosed) by a lining or membrane that forms around the edges. The pus collection (abscess) causes pressure on the spinal cord. The infection may cause inflammation and swelling, which also compresses the spinal cord.

The infection is usually bacterial, often a result of staphylococcus infection that spreads through the bones and membranes of the spine. In some rare cases, the infection may be fungal or viral. Tuberculosis is a cause of spinal cord abscess that is less common than in the past but still occurs in some areas of the world.

The risks include boils (furuncles) on the skin, particularly on the back or scalp. Abscess may also result from the spread of any infection through the bloodstream from another body location (bacteremia). Back injuries or trauma, including minor injuries, increase the risk of spinal cord abscess. Occasionally, spinal cord abscess may be a complication of lumbar puncture (spinal tap) or surgery on the back.

The initial infection often begins in the bone (osteomyelitis). The bone infection may trigger formation of an epidural abscess which enlarges and rapidly compresses the spinal cord, causing symptoms similar to those caused by exterior sources of spinal cord trauma.

The disorder is rare, but may be life-threatening.

• fever
• chills
• backache in the lower back
  • often mild
  • progressively worsening
  • typically radiating to hip, leg, or feet
  • may radiate to the shoulder, arm, or hand
• sudden or rapid progression of neurologic symptoms
• loss of movement of an area of the body
• weakness or paralysis
• loss of sensation of an area of the body
• numbness in a specific, limited area (localized)
• loss of bladder or bowel control
  • inability to retain feces (fecal incontinence)
  • unable to keep from leaking urine (urinary incontinence)
• male impotence

• A CSF examination may be normal or may contain a few white blood cells and slightly elevated protein levels.
• A CT scan or MRI confirm epidural abscess. Dye may be necessary for CT scan to show a clear picture of the abscess.
• A culture of material obtained by surgical drainage of the abscess will determine the specific microorganism(s) responsible for the infection.

• recurrence of spinal cord abscess
• formation of fibrous spinal cord mass
• spinal cord compression, life threatening
• permanent neurologic losses (variable)
  • weakness, paralysis
  • loss of sensation
  • loss of bladder/bowel control
  • male impotence
  • other losses