The effectiveness of negative pressure wound therapy in the treatment of spinal epidural abscesses

Abstract

Background. Retrodural spinal epidural abscess (RSEA) is a rare form of purulent lesions of the spine and spinal cord and accounts for 0.22% of all pathology of the spinal column, it is often accompanied by neurological disorders. Diagnosis of RSEA is extremely difficult and often problematic. The purpose of the study is to evaluate the effectiveness of negative pressure wound therapy in the surgical treatment of RSEA. Material and methods. The study included 23 patients who were operated on for retrodural spinal epidural abscess (RSEA): 13 patients underwent laminectomy with surgical debridement of the purulent focus and flow-lavage wound drainage, and 10 patients underwent decompression of neural structures and debridement according to the developed method (through interlaminar windows followed by negative pressure wound therapy). Results. The implementation of the developed method made it possible to reliably reduce the number of recurrent cases of RSEA (pFisheri = 0.0016), reduce the total time spent by patients in a hospital (pMann- Whitney = 0.004), and achieve recovery of neurological deficit according to the Frankel scale (pWilcoxon = 0.027). Conclusions. Negative pressure wound therapy is one of the most modern and effective methods in the treatment of purulent wounds. The use of this method in the treatment of RSEA has significantly improved the quality of medical care for patients with purulent diseases of the spine.

Keywords

• spinal epidural abscess
• negative pressure wound therapy
• interlaminectomy