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Minimally invasive transpedicular approach for evacuation of epidural abscess

| AANSNeurosurgery

Lee A. Tan, MD, Ippei Takagi, MD, Harel Deutsch, MD

Department of Neurosurgery, Rush University Medical Center

Spinal epidural abscess (SEA) often requires prompt surgical decompression to prevent potential devastating neurological deficits. Dorsally located SEA usually can be evacuated via simple laminectomies. Ventral SEA often requires an anterior approach such as thoracotomy to achieve adequate exposure and decompression. We report a case of ventral thoracic SEA associated with discitis and osteomyelitis that was successfully treated via minimally invasive transpedicular approach. The patient had immediate and dramatic symptomatic improvement and was ambulatory on post-operative day 1. The minimally invasive transpedicular approach avoids the surgical morbidity associated with anterior approach and is effective surgical alternative to treat ventral SEA.

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