Extensive epidural abscess with surgical treatment and long term follow up

• Published in: The spine journal 2007-11, Vol.7 (6), p.708-711
• Main Authors: Urrutia, Julio, MD, Rojas, Claudio
• Format: Article
• Language: English
• Subjects: Adult; Anti-Bacterial Agents - therapeutic use; Axis, Cervical Vertebra; Combined Modality Therapy; Epidural Abscess - drug therapy; Epidural Abscess - pathology; Epidural Abscess - surgery; Extensive epidural abscess; Follow-Up Studies; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - pathology; Gram-Positive Bacterial Infections - surgery; Humans; Laminectomy; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Orthopedics; Peptostreptococcus; Sacrum; Spinal epidural abscess; Spinal infection; Thoracic Vertebrae
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/j.spinee.2006.08.012

Abstract Background context Spinal epidural abscess is an uncommon infection. There are few reports on extensive epidural abscesses. Purpose We report a case of an epidural abscess extending from C2 to the sacrum, with a long-term follow-up. Study design A case report of an extensive epidural abscess with surgical treatment. Methods A 36-year-old male patient presented with a history of 15 days of fever and severe lumbar and neck pain. Magnetic resonance imaging disclosed an epidural abscess extending from C2 to the sacrum. Limited laminectomies were performed in the cervical, thoracic, and lumbar spine, and pus was obtained. A peptostreptococus grew in cultures. The patient received 6 weeks of antibiotics. Results The infection was successfully treated, and no neurological deficit was observed. The patient continued asymptomatic 5 years after surgery, and no deformity has developed. Conclusions A case of an extensive epidural abscess was successfully treated with limited laminectomies and antibiotics. This less invasive technique could treat the infection, and no late deformity has been observed.