open access

Vol 50, No 6 (2016)
Case reports
Submitted: 2016-04-05
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Oblique corpectomy for treatment of cervical spine epidural abscesses: Report on four cases

Przemysław Kunert, Marek Prokopienko, Arkadiusz Nowak, Tomasz Czernicki, Andrzej Marchel
DOI: 10.1016/j.pjnns.2016.08.001
·
Neurol Neurochir Pol 2016;50(6):491-496.

open access

Vol 50, No 6 (2016)
Case reports
Submitted: 2016-04-05

Abstract

Background

Spinal epidural abscesses (SEAs) in cervical locations are particularly life-threatening. Currently, SEAs are widely treated with bony decompression, followed by internal stabilization in purulent osteomyelitis. However, recently, a growing number of studies have reported minimally invasive approaches without internal fixation.

Purpose

We describe four patients with cervical SEAs that were evacuated by oblique corpectomy (OC) without fusion.

Methods

This study included two women and two men (aged 44–90) that received operations for removing ventral cervical SEAs. All patients presented with progressively increasing myelopathy, and 3 had severe comorbid conditions. In all cases, a multilevel OC without fusion was performed. The amount of bone resection was tailored to fit the needs of granulation removal, with an effort to retain as much of the vertebral bodies as possible. Then, pus was evacuated and debridement of granulation was performed, followed by rinsing and drainage.

Results

The neurological status of 3 patients improved significantly after surgery. At the last follow-up examination, one showed full recovery, and in two a minor residual deficit persisted. During mean follow-up of 5.5 years, no internal stabilization was necessary. The oldest patient was tetraplegic, and had several concomitant diseases. That patient died from sudden cardiac arrest on the third postoperative day. Oblique corpectomy did not affect the anterior or posterior column. Additionally, it provided a broad view of the ventral aspect of the spinal canal.

Conclusions

Oblique corpectomy allows appropriate spinal cord decompression and granulation removal in the case of cervical spine epidural abscess, without sacrificing spinal stability.

Abstract

Background

Spinal epidural abscesses (SEAs) in cervical locations are particularly life-threatening. Currently, SEAs are widely treated with bony decompression, followed by internal stabilization in purulent osteomyelitis. However, recently, a growing number of studies have reported minimally invasive approaches without internal fixation.

Purpose

We describe four patients with cervical SEAs that were evacuated by oblique corpectomy (OC) without fusion.

Methods

This study included two women and two men (aged 44–90) that received operations for removing ventral cervical SEAs. All patients presented with progressively increasing myelopathy, and 3 had severe comorbid conditions. In all cases, a multilevel OC without fusion was performed. The amount of bone resection was tailored to fit the needs of granulation removal, with an effort to retain as much of the vertebral bodies as possible. Then, pus was evacuated and debridement of granulation was performed, followed by rinsing and drainage.

Results

The neurological status of 3 patients improved significantly after surgery. At the last follow-up examination, one showed full recovery, and in two a minor residual deficit persisted. During mean follow-up of 5.5 years, no internal stabilization was necessary. The oldest patient was tetraplegic, and had several concomitant diseases. That patient died from sudden cardiac arrest on the third postoperative day. Oblique corpectomy did not affect the anterior or posterior column. Additionally, it provided a broad view of the ventral aspect of the spinal canal.

Conclusions

Oblique corpectomy allows appropriate spinal cord decompression and granulation removal in the case of cervical spine epidural abscess, without sacrificing spinal stability.

Get Citation

Keywords

Spinal epidural abscess, Oblique corpectomy, Cervical spine

About this article
Title

Oblique corpectomy for treatment of cervical spine epidural abscesses: Report on four cases

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 50, No 6 (2016)

Pages

491-496

DOI

10.1016/j.pjnns.2016.08.001

Bibliographic record

Neurol Neurochir Pol 2016;50(6):491-496.

Keywords

Spinal epidural abscess
Oblique corpectomy
Cervical spine

Authors

Przemysław Kunert
Marek Prokopienko
Arkadiusz Nowak
Tomasz Czernicki
Andrzej Marchel

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