To explore the diagnosis features of spinal epidural abscess (SEA).

The clinical data of 1 case of SEA without fever was analyzed retrospectively.Literatures were reviewed and features of clinical diagnosis of SEA were summarized.

The patient was an old man, and was admitted to department of spine surgery of Affiliated Hospital of Jining Medical University for low back pain and paralysis of lower limbs.He had a history of diabetes mellitus for more than 3 years without taking medicine to control his blood sugar.On admission, his body temperature was 36.8℃, blood sugar 8.2 mmol/L, initial white-cell count 10.80×10⁹/L (83.60% neutrophils), and serum C-reactive protein 82 mg/L.MRI revealed abnormal high signal in T_7-11 segment of intraspinal epidural space at admission.Decompressive laminectomy was performed urgently.During the operation, the white viscous pus in the spinal canal was observed and the pus was taken for bacterial culture.The result of bacterial culture was Staphylococcus aureus.Postoperative MRI scan which performed on the nineteenth day after surgery revealed the spine has been decompressed successfully.After 10 months follow-up, the lower limbs recovered.

Clinically, SEA is an uncommon disorder, and the early diagnosis of SEA is difficult, especially SEA without fever.The accurate diagnosis needs a combination of clinician experience, clinical manifestation in patients, laboratory examination and imaging assays.Patients with diabetes mellitus are the highest risk subgroup of SEA.When the diabetic patients with low back pain and the increase of inflammatory markers, spinal epidural abscess should be considered, although patient′s body temperature is normal.And further, MRI should be carried out to clarify the diagnosis.