Minimally Invasive Irrigation for Lumbar Spinal Epidural Abscess using a Trans-Sacral Epiduroscopic Laser Decompression Catheter

Abstract

We describe a case of a spinal epidural abscess that was successfully treated with minimally invasive irrigation using trans-sacral epiduroscopic laser decompression (SELD) catheter. A 66-year-old man experienced aggravating right leg pain and lower back pain for 1 month despite receiving several pain blocks at a local hospital. Magnetic resonance imaging scans showed annular fissure and bulging disc at the L4/5 level. Therefore, we decided to treat the L4/5 lesion using SELD. Laboratory studies demonstrated leukocytosis and elevated C-reactive protein level. However, we did not pay attention to the abnormal laboratory values before SELD. During SELD, we found a yellowish epidural abscess and pus drainage. Therefore, we irrigated the epidural abscess using an SELD catheter. His low back pain was relieved dramatically immediately after the procedure. The spinal epidural abscess completely resolved after 20 days of antibiotic treatment. Minimally invasive irrigation and drainage using a SELD catheter and intravenous antibiotic therapy are helpful for the treatment of spinal epidural abscess.

Keywords

• epidural abscess
• minimally invasive
• trans-sacral epiduroscopic laser decompression
• spondylodiscitis
• irrigation and drainage