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Operative management of an extensive spinal epidural abscess.

Choong Hoon Foo1, Khin Maung Ohn2, Tze Yang Ng3

  • 1Orthopaedic Department, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia.

BMJ Case Reports
|January 6, 2026
PubMed
Summary

This case report details an extensive spinal epidural abscess (SEA) from C2 to S1. Surgical intervention led to good neurological recovery for the patient with this rare central nervous system infection.

Keywords:
NeurosurgeryOrthopaedicsSpinal cord

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Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Spinal Medicine

Background:

  • Spinal epidural abscess (SEA) is a severe central nervous system infection.
  • SEA commonly presents with back pain, fever, and neurological deficits.
  • Extensive SEA cases are rare, posing diagnostic and therapeutic challenges.

Purpose of the Study:

  • To report a rare case of an extensive spinal epidural abscess (SEA) spanning from the cervical to the sacral spine.
  • To highlight the diagnostic findings and surgical management of such a large-scale infection.
  • To discuss the neurological recovery following surgical intervention.

Main Methods:

  • Magnetic Resonance Imaging (MRI) was used to diagnose the extent of the epidural abscess.
  • Surgical intervention included posterior spinal instrumentation and fusion.
  • Intraoperative findings documented solidified abscess material and liquefied pus.

Main Results:

  • An extensive SEA was identified, extending from C2 to S1.
  • Surgical decompression and fusion were performed from C6 to T8.
  • The patient experienced good neurological recovery and was discharged one month postoperatively.

Conclusions:

  • Extensive spinal epidural abscesses, though rare, require prompt diagnosis and aggressive surgical management.
  • Surgical intervention with spinal instrumentation and fusion can lead to favorable outcomes.
  • Early detection and treatment are crucial for neurological recovery in patients with extensive SEA.