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Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Global+Spine+J 2016 ; 6 (4): 383-93 Nephropedia Template TP
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Upper Cervical Epidural Abscess in Clinical Practice: Diagnosis and Management #MMPMID27190742
Al-Hourani K; Al-Aref R; Mesfin A
Global Spine J 2016[Jun]; 6 (4): 383-93 PMID27190742show ga
Study Design?Narrative review.Objective?Upper cervical epidural abscess (UCEA) is a rare surgical emergency. Despite increasing incidence, uncertainty remains as to how it should initially be managed. Risk factors for UCEA include immunocompromised hosts, diabetes mellitus, and intravenous drug use. Our objective is to provide a comprehensive overview of the literature including the history, clinical manifestations, diagnosis, and management of UCEA.Methods?Using PubMed, studies published prior to 2015 were analyzed. We used the keywords ?Upper cervical epidural abscess,? ?C1 osteomyelitis,? ?C2 osteomyelitis,? ?C1 epidural abscess,? ?C2 epidural abscess.? We excluded cases with tuberculosis.Results?The review addresses epidemiology, etiology, imaging, microbiology, and diagnosis of this condition. We also address the nonoperative and operative management options and the relative indications for each as reviewed in the literature.Conclusion?A high index of suspicion is required to diagnose this rare condition with magnetic resonance imaging being the imaging modality of choice. There has been a shift toward surgical management of this condition in recent times, with favorable outcomes.