Transforaminal Endoscopic Drainage of Massive Anterior Epidural Abscess-Novel Technique

Abstract

A 54 year old female presented with recent onset of fever, back pain, radicular pain with bowel and bladder paralysis. Magnetic resonance imaging with contrast revealed a massive anterior spinal epidural abscess extending from D10 to L4 with osteomyelitis of L4 vertebral body. Patient was treated with transforaminal endoscopic drainage of abscess. Abscess was drained using a Ryle's tube passed through the endoscope. Patients had relief from fever and radicular pain with improvement in back pain. Post operative magnetic resonance imaging scan showed drainage of abscess. Pus culture report showed growth of staphylococcus aureus. Patient was treated with antibiotic therapy according to culture report. Patient achieved complete neurological recovery three months after surgery. At two year follow up, patient was asymptomatic and MRI showed well decompressed cord and healed osteomyelitis L4 vertebral body. Transforaminal endoscopic drainage is safe and effective minimally invasive technique for anterior epidural abscess of thoracolumbar spine.

Expanded Indications of Full Endoscopic Spine Sugery

“…TELD has been used in spondylodiscitis and postoperative spondylodiscitis effectively the last two decades [95][96][97] . Even for anterior epidural abscess of thoracolumbar spine TELD, its safe outcome is reported 98) .…”