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Updated: Oct 11, 2025
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
Spinal Subdural Abscess Mimicking an Extradural Tumor: A Case Report
Nikolay A Konovalov1, Stanislav Kaprovoy1, Dmitry Asyutin1
1Department of Spinal and Peripheral Nerve Surgery, Burdenko Neurosurgical Center, Moscow, RUS.
Abstract:
Spinal subdural abscesses (SSAs) are rare pathologies presenting as encapsulated pus located intradurally and extramedullary. Although there is no uniform opinion on the cause of this pathology, approximately 50% of cases are attributed to Staphylococcus aureus infection. Here, we present a rare case of a female patient who presented to N.N. Burdenko Neurosurgical Center for treatment of an extradural tumor in the lower lumbar spine. She complained of acute lower back pain, lower limb muscle spasms, progressive lower limb weakness, numbness in toes, and increased frequency of defecation (five to six times per day). Intraoperatively, we discovered that the epidural space was clear and a subdural abscess was located and removed. The patient was started on antibiotics and recovered 29 days later. This case report illustrates an atypical SSA mimicking an extramedullary tumor on MRI.
Insights
Spinal subdural abscesses are rare, often caused by Staphylococcus aureus. This case highlights an atypical abscess mimicking a tumor on MRI, successfully treated with antibiotics.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Radiology
Background:
- Spinal subdural abscesses (SSAs) are uncommon, presenting as encapsulated pus within the dura mater.
- Staphylococcus aureus is implicated in approximately 50% of spinal subdural abscess cases.
- SSAs can present with diverse neurological symptoms, including back pain and motor deficits.
Observation:
- A female patient presented with symptoms suggestive of a lower lumbar extradural tumor.
- Imaging revealed a lesion mimicking an extramedullary tumor.
- Intraoperative findings confirmed a spinal subdural abscess, not an extradural tumor.
Findings:
- The spinal subdural abscess was successfully removed.
- The patient received antibiotic treatment post-operatively.
- Complete recovery was achieved within 29 days.
Implications:
- This case underscores the importance of considering atypical spinal subdural abscesses in differential diagnoses.
- Recognizing SSAs that mimic tumors on MRI is crucial for timely and appropriate management.
- Early diagnosis and treatment of SSAs are vital for favorable patient outcomes.
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