J Korean Orthop Assoc.  2009 Dec;44(6):680-685. 10.4055/jkoa.2009.44.6.680.

Unusual Spinal Epidural Abscess without Predisposing Factors Treated Using a Minimally Invasive Technique

• Song KJ
• Choi BW
• Kim GH
• Choi BR

• KMID: 2186296
• DOI: http://doi.org/10.4055/jkoa.2009.44.6.680

Abstract

Spinal epidural abscess (SEA) is an uncommon infectious disease that can have disastrous neurologic complications. Previous reports have identified underlying predisposing characteristics. Here, the authors report unusual 2 cases of multi-segment spinal epidural abscess, without predisposing conditions, which were successfully treated using a minimally invasive technique.

Keyword

Spinal epidural abscess; Multi-segment; Minimally invasive surgery

MeSH Terms

Communicable Diseases
Epidural Abscess

Figure

• 

  Fig. 1 Pre-operative magnetic resonance images of case 1. An epidural abscess was found to extend from the cervical to the lumbar spine (A, gadolinium-enhanced T1-weighted sagittal scan) and lead to spinal cord compression (B, T2-weighted axial scan).

• 

  Fig. 2 Intraoperative photo images of case 1. (A) After selective hemilaminectomy of T7 and L5, drainage, decompression, and irrigation were performed using a Two-Lumen Central Venous Catheterization set. (B) Post-operative photo showing separated minimal skin incisions.

• 

  Fig. 3 Post-operative T2-weighted magnetic resonance images of case 1 showing that most of the epidural abscess had disappeared (A) and that complete decompression of the spinal cord had been achieved (B).

Reference

1. Baker AS, Ojeman RG, Swartz MN, Richardson EP Jr. Spinal epidural abscess. N Engl J Med. 1975. 293:463–468.

2. Danner RL, Hartman BJ. Update of spinal epidural abscess: 35 cases and review of the literature. Rev Infect Dis. 1987. 9:265–274.

3. Ptaszynski AE, Hooten WM, Huntoon MA. The incidence of spontaneous epidural abscess in Olmsted County from 1990 through 2000: a rare cause of spinal pain. Pain Med. 2007. 8:338–343.

4. Schultz KD Jr, Comey CH, Haid RW Jr. Technical note. Pyogenic spinal epidural abscess: a minimally invasive technique for multisegmental decompression. J Spinal Disord. 2001. 14:546–549.

5. Lyu RK, Chen CJ, Tang LM, Chen ST. Spinal epidural abscess successfully treated with percutaneous, computed tomography-guided, needle aspiration and parenteral antibiotic therapy: case report and review of the literature. Neurosurgery. 2002. 51:509–512.

6. Choi CH, Kim HJ, Pai HJ, Park YS. Cervical and thoracolumbar epidural abscess: a case report. J Korean Soc Spine Surg. 2007. 14:105–109.

7. Reihsaus E, Waldbaur H, Seeling W. Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev. 2000. 23:175–204.

8. Wheeler D, Keiser P, Rigamonti D, Keay S. Medical management of spinal epidural abscesses: case report and review. Clin Infect Dis. 1992. 15:22–27.

9. Panagiotopoulos V, Konstantinou D, Solomou E, Panagiotopoulos E, Marangos M, Maraziotis T. Extended cervicolumbar spinal epidural abscess associated with paraparesis successfully decompressed using a minimally invasive technique. Spine (Phila Pa 1976). 2004. 29:E300–E303.