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Extensive Spinal Epidural Abscesses Resolved with Minimally Invasive Surgery: Two Case Reports and Review of the Recent Literature

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New Trends in Craniovertebral Junction Surgery

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 125))

Abstract

Purpose: An extensive spinal epidural abscess is a rare condition and causes significant morbidity and mortality. Few authors have described this uncommon entity, which requires early diagnosis and optimal treatment to avoid devastating complications. The purpose of this study was to evaluate a minimally invasive technique for treatment of an extensive spinal epidural abscess by describing two cases. Furthermore, we conducted a review of the recent literature on the management of this rare condition.

Methods: We report two cases of spinal abscesses extending to the whole epidural space, successfully treated by use of a minimally invasive technique consisting of multilevel laminotomy and catheter irrigation to decompress and drain the epidural space.

Results: This technique is able to decompress the spinal cord, isolate the pathogen and evacuate the abscess. No complications, late spine deformity or dura penetration were observed in our patients.

Conclusion: Urgent surgical decompression, in combination with long-term antibiotic treatment, is generally considered the treatment of choice for an extensive spinal epidural abscess. A minimally invasive technique can be very useful as a surgical option.

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Competing Interests

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. Spine Surgery Division, Agostino Gemelli Hospital, Catholic University of the Sacred Heart of Rome, Rome, Italy

    Luca Proietti, Giovanni Noia, Eugenio Valenzi, Andrea Perna, Ilaria Giannelli & Francesco Ciro Tamburrelli

  2. Institute of Neurological Surgery, Catholic University of the Sacred Heart of Rome, Agostino Gemelli Hospital, Rome, Italy

    Luca Ricciardi, Massimiliano Visocchi & Fabio Papacci

  3. Division of Orthopaedics and Traumatology, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy

    Giuseppe Barone

  4. Spine Surgery Division 1, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy

    Laura Scaramuzzo

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  1. Luca Proietti
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Editors and Affiliations

  1. Institute of Neurosurgery, Catholic University of Rome, Institute of Neurosurgery, Rome, Italy

    Massimiliano Visocchi

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No financial support was received for this work.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

The patients discussed in this paper have expressed their consent for the presentation of their cases and the processing of their personal data.

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Proietti, L. et al. (2019). Extensive Spinal Epidural Abscesses Resolved with Minimally Invasive Surgery: Two Case Reports and Review of the Recent Literature. In: Visocchi, M. (eds) New Trends in Craniovertebral Junction Surgery. Acta Neurochirurgica Supplement, vol 125. Springer, Cham. https://doi.org/10.1007/978-3-319-62515-7_50

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  • DOI: https://doi.org/10.1007/978-3-319-62515-7_50

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  • Publisher Name: Springer, Cham

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