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Paraspinal Abscess
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Paraspinal abscess (PA)
              • Definitions

                • Infection of soft tissues surrounding spine
                  • Phlegmon surrounding peripherally enhancing fluid collections

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Nuclear Medicine Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Jain NK et al: Radiologic evaluation and management of postoperative spine paraspinal fluid collections. Neuroimaging Clin N Am. 24(2):375-89, 2014
                                                2. Siddiq DM et al: Spinal and paraspinal pneumococcal infections-a review. Eur J Clin Microbiol Infect Dis. 33(4):517-27, 2014
                                                3. Low SY et al: Neisseria gonorrhoeae paravertebral abscess. J Neurosurg Spine. 17(1):93-7, 2012
                                                4. Acharya U: A case of atypical presentation of thoracic osteomyelitis & paraspinal abscess. Mcgill J Med. 11(2):164-7, 2008
                                                5. Hassan FO et al: Primary pyomyositis of the paraspinal muscles: a case report and literature review. Eur Spine J. 17 Suppl 2:S239-42, 2008
                                                6. Gaul C et al: Iatrogenic (para-) spinal abscesses and meningitis following injection therapy for low back pain. Pain. 116(3):407-10, 2005
                                                7. Okada F et al: Lumbar facet joint infection associated with epidural and paraspinal abscess: a case report with review of the literature. J Spinal Disord Tech. 18(5):458-61, 2005
                                                8. Crum NF: Bacterial pyomyositis in the United States. Am J Med. 117(6):420-8, 2004
                                                9. Martinez V et al: Tuberculous paravertebral abscess. Lancet. 363(9409):615, 2004
                                                10. Ledermann HP et al: MR imaging findings in spinal infections: rules or myths? Radiology. 228(2):506-14, 2003
                                                11. Eastwood JD et al: Diffusion-weighted imaging in a patient with vertebral and epidural abscesses. AJNR Am J Neuroradiol. 23(3):496-8, 2002
                                                12. Gouliamos AD et al: MR imaging of tuberculous vertebral osteomyelitis: pictorial review. Eur Radiol. 11(4):575-9, 2001
                                                13. Hill JS et al: A Staphylococcus aureus paraspinal abscess associated with epidural analgesia in labour. Anaesthesia. 56(9):873-8, 2001
                                                14. Tzen KY et al: The role of 67Ga in the early detection of spinal epidural abscesses. Nucl Med Commun. 21(2):165-70, 2000
                                                15. Veillard E et al: Prompt regression of paravertebral and epidural abscesses in patients with pyogenic discitis. Sixteen cases evaluated using magnetic resonance imaging. Joint Bone Spine. 67(3):219-27, 2000
                                                16. Cook NJ et al: Paraspinal abscess following facet joint injection. Clin Rheumatol. 18(1):52-3, 1999
                                                17. Raj V et al: Paraspinal abscess associated with epidural in labour. Anaesth Intensive Care. 26(4):424-6, 1998
                                                18. Staatz G et al: Spondylodiskitic abscesses: CT-guided percutaneous catheter drainage. Radiology. 208(2):363-7, 1998
                                                19. Baltz MS et al: Lumbar facet joint infection associated with epidural and paraspinal abscess. Clin Orthop. (339):109-12, 1997
                                                20. Bertol V et al: Neurologic complications of lumbar epidural analgesia: spinal and paraspinal abscess. Neurology. 48(6):1732-3, 1997
                                                21. Cecil M et al: Paraspinal pyomyositis, a rare cause of severe back pain: case report and review of the literature. Am J Orthop. 26(11):785-7, 1997
                                                22. Pascaretti C et al: Epidural involvement in nontuberculous disk space infections. Incidence by magnetic resonance imaging, impact and prognosis. Rev Rhum Engl Ed. 64(10):556-61, 1997
                                                23. Dagirmanjian A et al: MR imaging of vertebral osteomyelitis revisited. AJR Am J Roentgenol. 167(6):1539-43, 1996
                                                24. Nussbaum ES et al: Spinal tuberculosis: a diagnostic and management challenge. J Neurosurg. 83(2):243-7, 1995
                                                25. Shanley DJ: Tuberculosis of the spine: imaging features. AJR Am J Roentgenol. 164(3):659-64, 1995
                                                26. Pegues DA et al: Infectious complications associated with temporary epidural catheters. Clin Infect Dis. 19(5):970-2, 1994
                                                27. Post MJ et al: Magnetic resonance imaging of spinal infection. Rheum Dis Clin North Am. 17(3):773-94, 1991
                                                28. Smevik B et al: Computed tomography of a tuberculous paravertebral abscess. Z Kinderchir. 43(6):430-2, 1988
                                                29. Lee JK et al: Psoas muscle disorders: MR imaging. Radiology. 160(3):683-7, 1986
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Paraspinal abscess (PA)
                                                            • Definitions

                                                              • Infection of soft tissues surrounding spine
                                                                • Phlegmon surrounding peripherally enhancing fluid collections

                                                            IMAGING

                                                            • General Features

                                                              • Radiographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Ultrasonographic Findings

                                                                      • Nuclear Medicine Findings

                                                                        • Imaging Recommendations

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Jain NK et al: Radiologic evaluation and management of postoperative spine paraspinal fluid collections. Neuroimaging Clin N Am. 24(2):375-89, 2014
                                                                                              2. Siddiq DM et al: Spinal and paraspinal pneumococcal infections-a review. Eur J Clin Microbiol Infect Dis. 33(4):517-27, 2014
                                                                                              3. Low SY et al: Neisseria gonorrhoeae paravertebral abscess. J Neurosurg Spine. 17(1):93-7, 2012
                                                                                              4. Acharya U: A case of atypical presentation of thoracic osteomyelitis & paraspinal abscess. Mcgill J Med. 11(2):164-7, 2008
                                                                                              5. Hassan FO et al: Primary pyomyositis of the paraspinal muscles: a case report and literature review. Eur Spine J. 17 Suppl 2:S239-42, 2008
                                                                                              6. Gaul C et al: Iatrogenic (para-) spinal abscesses and meningitis following injection therapy for low back pain. Pain. 116(3):407-10, 2005
                                                                                              7. Okada F et al: Lumbar facet joint infection associated with epidural and paraspinal abscess: a case report with review of the literature. J Spinal Disord Tech. 18(5):458-61, 2005
                                                                                              8. Crum NF: Bacterial pyomyositis in the United States. Am J Med. 117(6):420-8, 2004
                                                                                              9. Martinez V et al: Tuberculous paravertebral abscess. Lancet. 363(9409):615, 2004
                                                                                              10. Ledermann HP et al: MR imaging findings in spinal infections: rules or myths? Radiology. 228(2):506-14, 2003
                                                                                              11. Eastwood JD et al: Diffusion-weighted imaging in a patient with vertebral and epidural abscesses. AJNR Am J Neuroradiol. 23(3):496-8, 2002
                                                                                              12. Gouliamos AD et al: MR imaging of tuberculous vertebral osteomyelitis: pictorial review. Eur Radiol. 11(4):575-9, 2001
                                                                                              13. Hill JS et al: A Staphylococcus aureus paraspinal abscess associated with epidural analgesia in labour. Anaesthesia. 56(9):873-8, 2001
                                                                                              14. Tzen KY et al: The role of 67Ga in the early detection of spinal epidural abscesses. Nucl Med Commun. 21(2):165-70, 2000
                                                                                              15. Veillard E et al: Prompt regression of paravertebral and epidural abscesses in patients with pyogenic discitis. Sixteen cases evaluated using magnetic resonance imaging. Joint Bone Spine. 67(3):219-27, 2000
                                                                                              16. Cook NJ et al: Paraspinal abscess following facet joint injection. Clin Rheumatol. 18(1):52-3, 1999
                                                                                              17. Raj V et al: Paraspinal abscess associated with epidural in labour. Anaesth Intensive Care. 26(4):424-6, 1998
                                                                                              18. Staatz G et al: Spondylodiskitic abscesses: CT-guided percutaneous catheter drainage. Radiology. 208(2):363-7, 1998
                                                                                              19. Baltz MS et al: Lumbar facet joint infection associated with epidural and paraspinal abscess. Clin Orthop. (339):109-12, 1997
                                                                                              20. Bertol V et al: Neurologic complications of lumbar epidural analgesia: spinal and paraspinal abscess. Neurology. 48(6):1732-3, 1997
                                                                                              21. Cecil M et al: Paraspinal pyomyositis, a rare cause of severe back pain: case report and review of the literature. Am J Orthop. 26(11):785-7, 1997
                                                                                              22. Pascaretti C et al: Epidural involvement in nontuberculous disk space infections. Incidence by magnetic resonance imaging, impact and prognosis. Rev Rhum Engl Ed. 64(10):556-61, 1997
                                                                                              23. Dagirmanjian A et al: MR imaging of vertebral osteomyelitis revisited. AJR Am J Roentgenol. 167(6):1539-43, 1996
                                                                                              24. Nussbaum ES et al: Spinal tuberculosis: a diagnostic and management challenge. J Neurosurg. 83(2):243-7, 1995
                                                                                              25. Shanley DJ: Tuberculosis of the spine: imaging features. AJR Am J Roentgenol. 164(3):659-64, 1995
                                                                                              26. Pegues DA et al: Infectious complications associated with temporary epidural catheters. Clin Infect Dis. 19(5):970-2, 1994
                                                                                              27. Post MJ et al: Magnetic resonance imaging of spinal infection. Rheum Dis Clin North Am. 17(3):773-94, 1991
                                                                                              28. Smevik B et al: Computed tomography of a tuberculous paravertebral abscess. Z Kinderchir. 43(6):430-2, 1988
                                                                                              29. Lee JK et al: Psoas muscle disorders: MR imaging. Radiology. 160(3):683-7, 1986