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Intradural Extension of a Pyogenic Epidural Abscess

A Case Report

Rosinsky, Philip J., MD1; Zimhony, Oren, MD1; Ciobotaro, Pnina, MD1; Sagiv, Shaul, MD1; Ben-Galim, Peleg, MD1

doi: 10.2106/JBJS.CC.N.00253
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Disclosures

Case: Few cases of spinal epidural abscess involving an extradural abscess with an intradural extension have been reported. A unique complication with extension of pus from the epidural space through multiple perforations into the dura is described. Due to a proximal meningeal inflammatory reaction, which served as a proximal plug, no cerebrospinal fluid leak was encountered.

Conclusion: Intradural extension of pus through multiple dural perforations is a rare complication of spinal epidural abscess and a treatment challenge. Early diagnosis enabling prompt surgical decompression, along with subsequent aggressive debridements and prolonged intravenous antibiotic treatment, can lead to a favorable outcome.

1Department of Orthopedic Surgery (P.J.R., S.S., and P. B.-G.) and Infectious Diseases Unit (O.Z. and P.C.), Kaplan Medical Center, Pasternak Street, P.O.B. 1, Rehovot 76100, Israel. E-mail address for P.J. Rosinsky: prosinsky@gmail.com. E-mail address for O. Zimhony: Oren_Z@clalit.org.il. E-mail address for P. Ciobotaro: PninaCi@clalit.org.il. E-mail address for S. Sagiv: sagiv2524@gmail.com. E-mail address for P. Ben-Galim: pelegbg@gmail.com

Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated
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