We present the case of a patient with low back pain who rapidly progressed to cauda equina syndrome due to an extended epidural abscess of the thoracic, lumbar and sacral spine. The patient was successfully treated with surgical decompression through laminectomies at L1, L3 and L5 levels and surgical drainage of the epidural pus. Six-week course of intravenous antibiotic therapy followed. At 6-month follow-up examination, complete return of extremity motor function was demonstrated and the patient reported resolution of pain. Although, medical treatment with or without aspiration of the epidural space is increasingly used in patients without neurological deficits, in those with neurological deficits the importance of early decompression and debridement of infected tissues should be emphasized. A minimal surgical technique can be adequate for pus drainage as well as for preventing spinal instability in the setting of an extended spinal epidural abscess.
Konstantinos Barkas, Emmanouel Chatzidakis, Panagiotis Zogopoulos and Moschos Fratzoglou