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Updated: Jul 20, 2026
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
Intramedullary spinal cord abscess as postoperative complication: A case report
Amber Lynn Valeri1, Adam Alayli2, Jonah Gordon2
1Department of Neurosurgery, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States.
Background:
Intramedullary spinal cord abscesses (ISCA) can result in high morbidity and mortality if not treated in a timely manner. The incidence and outcomes of postsurgical ISCA are unknown. We present a case of a 52-year-old male patient with neurofibromatosis type 1 who developed an intramedullary spinal cord abscess after a previous resection of a cervical intradural, extramedullary neurofibroma.
Case Description:
A 52-year-old male with a history of neurofibromatosis type 1 had previously undergone multiple resections of cervical intradural, extramedullary neurofibromas with internal stabilization. Sixteen months after his initial surgery, he developed acute-onset interscapular pain with bilateral lower extremity pain and left hemi-body weakness. Magnetic resonance imaging (MRI) of the cervical spine demonstrated an enlarging contrast-enhancing intramedullary lesion. Surgical exploration and evacuation of the lesion were completed. Intramedullary cultures confirmed a Serratia marcescens abscess. After abscess evacuation and intravenous antibiotics, the patient's symptoms resolved.
Conclusion:
Given the potential for permanent neurologic damage and loss of independence with intramedullary spinal cord abscess, we advocate that clinicians maintain a high index of suspicion in the postsurgical patient. Diagnostic imaging through contrasted MRI or computed tomography myelogram should be obtained, and prompt intervention, including evacuation and/or antibiotics, should be implemented for the best chance of a favorable outcome.
Insights
Postsurgical intramedullary spinal cord abscesses (ISCA) are rare but serious. Prompt diagnosis and intervention, including surgical evacuation and antibiotics, are crucial for favorable outcomes in neurosurgery patients.
Area of Science:
- Neurosurgery
- Infectious Disease
- Spinal Cord Pathology
Background:
- Intramedullary spinal cord abscesses (ISCA) present a significant risk of morbidity and mortality.
- The incidence and outcomes of postsurgical ISCA remain largely uncharacterized.
- This case highlights a rare complication following spinal neurofibroma resection.
Observation:
- A 52-year-old male with neurofibromatosis type 1 developed ISCA 16 months post-spinal surgery.
- Symptoms included acute pain and progressive neurological deficits.
- MRI revealed an enlarging intramedullary lesion.
Findings:
- Surgical evacuation successfully removed the abscess.
- Cultures identified *Serratia marcescens* as the causative agent.
- The patient's neurological symptoms resolved following treatment.
Implications:
- Clinicians should maintain a high suspicion for ISCA in postsurgical patients.
- Prompt diagnostic imaging (contrast MRI or CT myelogram) is essential.
- Early surgical intervention and antibiotic therapy improve patient outcomes and prevent permanent neurologic damage.
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