The empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting. Laminectomy is the treatment of choice once the provisional diagnosis is made. The dura mater is closed preferably with a graft, if needed, once the decompression has been accomplished. Although marsupialization has been tried occasionally, it generally is not recommended. Currently, with prompt diagnosis, early surgery, and correct antibiotic therapy, the chances for full or almost full recovery often are very good.
Early surgery is the key to recovery in acute cases.
Prognosis generally is better in chronic and subacute cases. Graph showing age distribution of 91 patients with intramedullary spinal cord abscess. A case report. Intramedullary epidermoid associated with an intramedullary spinal abscess secondary to a dermal sinus. Chronic intramedullary abscess of the spinal cord.