Operative management of an extensive spinal epidural abscess

Spinal epidural abscess (SEA) is a serious infection of the central nervous system that typically presents with midline back pain, fever and neurological deficits. We report a rare case of an extensive SEA extending from C2 to S1. The patient presented with neck pain, fever and progressive neurological deficits. MRI revealed a long-segment epidural abscess spanning the cervical, thoracic, lumbar and sacral spine. Surgical intervention involved posterior spinal instrumentation and fusion from C6 to T8. Intraoperatively, solidified abscess material was found encasing the spinal canal between C6 and T8, along with 7 cc of liquefied pus. The patient demonstrated good neurological recovery and was discharged 1 month postoperatively.