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

Extensive spinal epidural abscess is an uncommon and potentially life-threatening condition that mandates appropriate early diagnosis and treatment to avoid potentially disastrous complications. Limited literature is available guiding the management of such an entity.

The authors report the case of a 59-year-old female patient with a history of 5 days of severe back pain, fever, and associated lower limb neurological deficit. MRI revealed an epidural abscess extending from C2 to the sacrum. One-level segmental decompression was performed at the level of L2-3 in combination with the use of an epidurally introduced silicone catheter. Cultures came back positive for methicillin-resistant Staphylococcus aureus. The patient received 6 weeks of antibiotics. The infection was successfully treated after surgery and systemic antibiotic therapy, and full neurological recovery was observed.

This is the first report in the literature to describe successful surgical management of an extensive C2-S1 epidural abscess through a single incision and one-level decompression. This less invasive technique could treat the holospinal abscess without the need for other procedures. https://thejns.org/doi/10.3171/CASE24654.