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

  • Luca Proietti
  • Luca Ricciardi
  • Giovanni Noia
  • Giuseppe Barone
  • Eugenio Valenzi
  • Andrea Perna
  • Ilaria Giannelli
  • Laura Scaramuzzo
  • Massimiliano Visocchi
  • Fabio Papacci
  • Francesco Ciro Tamburrelli
Chapter
Part of the Acta Neurochirurgica Supplement book series (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.

Keywords

Extensive spinal epidural abscess Holocord abscess Minimally invasive surgery 

Notes

Competing Interests

The authors declare that they have no competing interests.

Compliance with Ethical Standards

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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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Luca Proietti
    • 1
  • Luca Ricciardi
    • 2
  • Giovanni Noia
    • 1
  • Giuseppe Barone
    • 3
  • Eugenio Valenzi
    • 1
  • Andrea Perna
    • 1
  • Ilaria Giannelli
    • 1
  • Laura Scaramuzzo
    • 4
  • Massimiliano Visocchi
    • 2
  • Fabio Papacci
    • 2
  • Francesco Ciro Tamburrelli
    • 1
  1. 1.Spine Surgery Division, Agostino Gemelli HospitalCatholic University of the Sacred Heart of RomeRomeItaly
  2. 2.Institute of Neurological SurgeryCatholic University of the Sacred Heart of Rome, Agostino Gemelli HospitalRomeItaly
  3. 3.Division of Orthopaedics and Traumatology, Santa Maria della Misericordia HospitalUniversity of PerugiaPerugiaItaly
  4. 4.Spine Surgery Division 1IRCCS Galeazzi Orthopaedic InstituteMilanItaly

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