Clinical features

The clinical features of a spinal abscess depend on the stage at which it presents:

• acute:
  • severe pain at the level of the abscess, exacerbated by movement and associated with local muscle spasm
  • neck stiffness
  • patient systemically unwell
  • neurological dysfunction with increasing cord compression
  • eventually, thrombophlebitis of the dural and cord vessels with subsequent total hemiplegia and loss of sphincter function.
    
• chronic - for example, tuberculous abscesses:
  • low-grade systemic malaise
  • slowly-progressing neurological dysfunction
  • occasional acute deterioration due to vertebral collapse

Reference

1. Sharfman ZT et al. Spinal Epidural Abscess: A Review of Presentation, Management, and Medicolegal Implications. Asian Spine J. 2020 Oct;14(5):742-759