spinal epidural abscess

EM Cases: Lower Back Pain Emergencies

In this episode we go through seven cases that display the breadth of presentations of limb or life threatening causes of low back pain emergencies with my huge mentors, Dr. Walter Himmel and Dr. Brian Steinhart. We cover everything from spinal epidural abscess to cauda equina syndrome to retroperitoneal bleeds, elucidating the key historical, physical exam, lab, imaging and treatment pearls for all of these diagnoses. We then go on to review the best management for the most common cause of back pain presentation, lumbosacral strain and debate the various medication options.

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Spinal Epidural Abscess

“Once the classic symptoms appear and a definitive diagnosis is made, the very symptoms we look for have often become irreversible”

  • Spinal epidural abscess is an extremely rare diagnosis but a potentially devastating one.
  • It has proven to be a difficult ER diagnosis.
  • Unfortunately, once the classic symptoms appear and a definitive diagnosis is made, the very symptoms we look for have often become irreversible.
  • How can we change the way we evaluate for SEA in order to minimize diagnostic delay and thereby decrease morbidity/mortality?

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