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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.
- Less useful for acute diagnosis since CRP levels rise faster and return to baseline faster than ESR
References
Reihsaus E, et al. Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev 2000.