Cervical, Thoracic, and Lumbar Spine Epidural Abscess: Case Report and Literature Review

Pus in Spinal Needle: Diagnosis and Management of a Long-Segment Spinal Epidural Abscess

Spinal-epidural abscess (SEA) is believed to be primarily of haematogenous origin and very rarely as a consequence of central neuraxial blockade. Early diagnosis and pertinent management invariably improve neurological outcomes. We report a case of long-segment SEA, which was suspected during subarachnoid anaesthesia, subsequently diagnosed and managed appropriately, averting irreversible neurological deficits.

Anterior transcorporeal full-endoscopic drainage of a long-span ventral cervical epidural abscess: A novel surgical technique

BACKGROUND

A long-span ventral cervical epidural abscess is a rare and devastating condition. Typically, extensive procedures are chosen to deal with this condition and usually end up with limited cervical motion. Here, we describe a novel minimally invasive anterior full-endoscopic transcorporeal approach for drainage of large ventral cervical epidural abscess.

CASE DESCRIPTION

A 33-year-old man presented with seizures and acute weakness in all extremities persistent for 2 hours. His motor power of the upper and lower extremities was rapidly declined from grade III to grade 0 within 12 hours. Magnetic resonance imaging (MRI) showed a long-span ventral epidural abscess extending from C2 to T1, cervical spinal cord, and a retropharyngeal abscess. A typical anterior cervical approach to the prevertebral space was performed to evacuate pus from the retropharyngeal abscess, after which anterior transcorporeal full-endoscopic drainage of the large ventral cervical epidural abscess was successfully performed.

OUTCOME

The patient's motor power recovered to grade IV within 2 weeks post-operation. He had no neck pain or instability following the operation. Postoperative MRI and computed tomography revealed diminished epidural abscess.

CONCLUSIONS

For managing cases with a ventral-type cervical epidural abscess, anterior transcorporeal full-endoscopic drainage is an alternative minimally invasive method that yields sufficient debridement and drainage.