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. 1997 Sep;6(5):332–335. doi: 10.1007/BF01142681

Surgical decompression: a life-saving procedure for an extensive spinal epidural abscess

K S Lam 1, K C Pande 1, H Mehdian 1,✉
PMCID: PMC3454605  PMID: 9391805

Abstract

Extensive spinal epidural abscesses (SEAs) carry a high mortality rate. Traditionally they are treated non-operatively with longterm antibiotics and/or surgical decompression, but there is a continuing debate as to whether they should be managed by emergency surgical decompression. However, such decisions are made in the light of the clinical setting. We report the successful management of a female patient who presented with features of upper cervical cord compression and later developed septic shock and multisystem failure. Surgical decompression of the cervical spine and irrigation of the epidural space with a paediatric catheter was performed followed by tricortical strut grafting and plating. At review, 36 weeks after surgery, the patient remained asymptomatic, having made full neurological recovery. The purpose of this report is to highlight the importance of emergency surgical intervention for extensive SEA in the presence of progressive neurological loss associated with multisystem failure.

Key words: Spinal epidural abscess, Spinal decompression, Spinal irrigation

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