• Salman Riaz
  • James K. Mahmood


Spinal epidural abscess (SEA) is a rare clinical entity associated with a high morbidity andmortality. It usually spans 3-4 levels. The literature contains very few reports of extensive orpanspinal epidural abscesses and hence there is no consensus on management of such cases. Wedescribe a case of 56 years old male presenting with a posteriorly located SEA extending from theForamen Magnum to thoracolumbar junction. The abscess had led to quadriparesis for the last 24hours. This abscess was treated operatively by performing noncontiguous minimally invasivedecompressions of the cervical and thoracic spine. The patient showed progressive improvementin neurologic status and was walking with minimal support at 4 months of follow-up.Keywords: Epidural; Abscess; Paralysis; Thoracic; Laminectomy; Ambulation.


Baker AS, Ojemann RG, Swartz MN, Richardson EP Jr.

Spinal epidural abscess. N Engl J Med 1975; 293:463-468.

Hlavin ML, Kaminski HJ, Ross JS, Ganz E. Spinal epidural

abscess: a ten-year perspective. Neurosurgery1990; 27:177–

Pilkington SA, Jackson SA, Gillett GR. Spinal epidural

empyema. Br J Neurosurg 2003;17:196–200..

Bluman EM, Palumbo MA, Lucas PR. Spinal epidural abscess

in adults. J Am Acad Orthop Surg 2004;12(3):155-63.

Reihsaus E, Waldbaur H, Seeling W: Spinal epidural abscess:

a meta-analysis of 915 patients. Neurosurg Rev 2000; 23:175-

Davis DP, Wold RM, Patel RJ, Tran AJ, Tokhi RN, Chan TC

et al. The clinical presentation and impact of diagnostic delays

on emergency department patients with spinal epidural

abscess. J Emerg Med 2004; 26:285–91.

Savage K, Holtom PD, Zalavras CG. Spinal epidural abscess:

early clinical outcome in patients treated medically. Clin

Orthop Relat Res 2005;439:56-60.

Schultz KD Jr, Comey CH, Haid RW Jr. Technical note.

Pyogenic spinal epidural abscess: a minimally invasive

technique for multisegmental decompression.

J Spinal Disord 2001;14(6):546-9.

Panagiotopoulos V, Konstantinou D, Solomou E,

Panagiotopoulos E, Marangos M, Maraziotis T. Extended

cervicolumbar spinal epidural abscess associated with

paraparesis successfully decompressed using a minimally

invasive technique. Spine 2004;29(14):E300-3.