Catheter-based Minimally Invasive Evacuation of Extensive Spinal Epidural Abscess: A Technical Report

Surgical treatment of extensive spinal epidural abscess (SEA) usually involves multilevel exposure of the dural sac with subsequent risk for iatrogenic instability. A minimally invasive technique using an epidural catheter inserted through a limited approach for distant irrigation and drainage of the abscess represents an interesting alternative. Most described techniques involve blind placement of the catheters, with the potential risk of damage to the spinal cord and incomplete abscess drainage. We present and analyze a new technique used in two cases of SEA. Those were successfully treated using a minimally invasive approach supplemented with fluoroscopically-guided catheter drainage. We suggest that fluoroscopic placement of the catheter is a safe and effective method that offers a more focused and potentially safer way to proceed to this technique.