Extensive spinal epidural abscess treated utilizing a single limited incision: illustrative case

Area of Science:

• Neurosurgery
• Infectious Disease

Background:

• Extensive spinal epidural abscesses are rare but life-threatening, requiring prompt diagnosis and treatment.
• Limited guidance exists for managing these extensive infections.

Purpose of the Study:

• To report a novel surgical approach for treating a holospinal epidural abscess.
• To demonstrate the efficacy of a less invasive technique for extensive spinal epidural abscess.

Main Methods:

• A 59-year-old female with C2-S1 epidural abscess underwent single-incision, one-level decompression at L2-3 with an epidural catheter.
• Postoperative treatment included 6 weeks of antibiotics for methicillin-resistant Staphylococcus aureus.

Main Results:

• Successful treatment of the extensive C2-S1 epidural abscess was achieved.
• The patient experienced full neurological recovery.
• Cultures identified methicillin-resistant Staphylococcus aureus.

Conclusions:

• This is the first report of successful surgical management of a C2-S1 epidural abscess using a single incision and one-level decompression.
• This less invasive technique effectively treated the holospinal abscess without additional procedures.