Surgical treatment for thoracosacral concomitant spinal epidural and subdural abscess: a case report

Abstract

The incidence of spinal infection seems to be on the rise owing to increases in the aging population, diabetes mellitus, intravenous drug abuse, epidural catheter use, and systemic immunodeficiency [1, 2]. Spinal epidural abscess (SEA) is an uncommon disease that was first described in 1761 [3]. The incidence was reported to be as high as 12.5 cases per 10,000 hospital admissions [4]. The most common source of infection is hematogenous spread. Spinal subdural abscess (SSA) is a rarer disease and was first described in 1927 [5]. The exact incidence is unknown [6, 7]. Almost 60 cases have been reported to date in PubMed. The route of spread is also usually hematogenous, and the most common source is the skin [6]. Either condition requires the administration of antibiotics, with additional surgical intervention in severe cases. The concomitant condition is very rare, and to our knowledge, this is the first report in English of thoracosacral concomitant spinal epidural and subdural abscess associated with arachnoiditis that was successfully treated by open decompression.