In the acute situation, surgical drainage of a spinal abscess is required to maintain neurological function. If there is vertebral body collapse, anterior decompression is needed and this is supplemented by a bone graft to aid stabilization.
Alternatively, the abscess is drained by laminectomy, or in the very frail patient, a needle guided by CT scan.
Antibiotics complement drainage, the drug being changed according to sensitivity results after culture, e.g. flucloxacillin and fusidic acid for Staph. spp. Therapy is continued for at least six weeks, or six to twelve weeks in the case of spinal tuberculosis.
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