Cervical epidural abscess after epidural steroid injection

Study Design. This is a case report of a cervical epidural abscess presenting with neurologic deficits after cervical epidural steroid injection. Objective. To describe the presentation, diagnosis, treatment, and outcome of a rare complication of cervical epidural steroid injection. Summary of Background Data. Cervical epidural steroid injections are a commonly used modality in the treatment of cervical spine disease. Serious complications from the procedure are rare. There is only one previously reported case of cervical epidural abscess after cervical epidural injection in the literature. Materials and Methods. A case of cervical epidural abscess after epidural steroid injection is presented and the relevant literature is reviewed. Results. The patient had partial recovery of neurologic function within the first 24 hours after decompressive laminectomy, irrigation, and debridement. There were no perioperative complications. Intraoperative cultures permitted positive identification of the infecting organism and appropriate antibiotic selection. At 7- month followup, there was no recurrence of infection and the patient had recovered baseline neurologic function and neck pain status. Conclusions. Cervical epidural abscess is a rare but potentially devastating complication after epidural steroid injection. Neurologic compromise may occur. Timely diagnosis and appropriate treatment may result in good clinical outcomes.