J Minim Invasive Spine Surg Tech.  2020 Oct;5(2):76-80. 10.21182/jmisst.2020.00164.

Transforaminal Endoscopic Drainage of Massive Anterior Epidural Abscess-Novel Technique

• Mahesha K

• KMID: 2562068
• DOI: http://doi.org/10.21182/jmisst.2020.00164

Abstract

A 54 year old female presented with recent onset of fever, back pain, radicular pain with bowel and bladder paralysis. Magnetic resonance imaging with contrast revealed a massive anterior spinal epidural abscess extending from D10 to L4 with osteomyelitis of L4 vertebral body. Patient was treated with transforaminal endoscopic drainage of abscess. Abscess was drained using a Ryle’s tube passed through the endoscope. Patients had relief from fever and radicular pain with improvement in back pain. Post operative magnetic resonance imaging scan showed drainage of abscess. Pus culture report showed growth of staphylococcus aureus. Patient was treated with antibiotic therapy according to culture report. Patient achieved complete neurological recovery three months after surgery. At two year follow up, patient was asymptomatic and MRI showed well decompressed cord and healed osteomyelitis L4 vertebral body. Transforaminal endoscopic drainage is safe and effective minimally invasive technique for anterior epidural abscess of thoracolumbar spine.

Keyword

Endoscopic drainage; Epidural abscess; Transforaminal endoscopy