Laboratory testing for Spinal Epidural Abscess

CBC

The CBC is poorly sensitive/specific

The WBC count may be nml or elevated

Left shift and bandemia may or may not be present

ESR and CRP

Sensitive but not specific

Elevated in >80% with vertebral osteomyelitis.

• Sensitive for spinal infection, but not extremely specific.

 

• ESR
  • ESR was elevated in 94-100% of patients with SEA vs. only 33% of non-SEA patients
• CRP
  • Less useful for acute diagnosis since CRP levels rise faster and return to baseline faster than ESR
    • Elevated CRP seen in 87% of patients with SEA as well as in 50% of patients with spine pain not due to a SEA
  • Better used as a marker of response to treatment.

 

 

 

References

Reihsaus E, et al. Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev 2000.