{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T02:44:28Z","timestamp":1775616268614,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100010029","name":"Taishan Scholar Foundation of Shandong Province","doi-asserted-by":"publisher","award":["tstp20250511"],"award-info":[{"award-number":["tstp20250511"]}],"id":[{"id":"10.13039\/501100010029","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Spinal epidural abscess (SEA) is a life\u2010threatening spinal infection with a pressing need for timely and effective surgical intervention. Conventional surgical approaches for SEA are often accompanied by extensive spinal tissue trauma and impaired spinal stability. This study retrospectively evaluates the efficacy of selective intersegmental laminectomy with irrigation (SILI), aiming to confirm that skip\u2010level laminectomies combined with intraspinal direct irrigation can achieve effective abscess evacuation for SEA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      After ethics committee approval and patient consent, the authors studied patients with \u2265\u20093 affected segments and neurological deficits who had SILI from March 2020 to July 2024. Patients who had conventional continuous multisegmental laminectomy with drainage (CMLD) at the same time were controls. Inflammatory markers (WBC, CRP, ESR) were analyzed. MRI results were used to see changes in abscess volume and dura mater sac area. SILI's effect on neurological function was evaluated with 3, 6, and 12\u2009months following up using JOA score, VAS, and modified MacNab criteria. Parametric tests (paired\/independent\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test, repeated\u2010measures ANOVA) were for normal data, nonparametric (Friedman test, Mann\u2013Whitney U test, Chi\u2010square test) for nonnormal and categorical data, with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 for significance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All procedures were completed successfully without major complications. Significant improvements were observed across all outcome domains: inflammatory markers demonstrated substantial reductions, with WBC count decreasing from 13.44\u2009\u00b1\u20092.38 to 8.56\u2009\u00b1\u20092.26\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), C\u2010reactive protein declining from 80.11\u2009\u00b1\u200921.43\u2009mg\/L to 21.18\u2009\u00b1\u20099.7\u2009mg\/L (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and erythrocyte sedimentation rate falling from 93.55\u2009\u00b1\u200921.75\u2009mm\/h to 29.74\u2009\u00b1\u20099.21\u2009mm\/h (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Radiographically, MRI measurements revealed a significant reduction in abscess axial area and abscess volume, alongside effective dural sac area expansion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Functionally, both JOA scores and pain VAS scores showed statistically significant improvement (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Modified MacNab criteria documented a clinically meaningful increase in \u201cExcellent rate\u201d outcomes from 55.56% at 3\u2009months to 91.67% at 12\u2009months postoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Interestingly, the SILI technique produced better results in terms of JOA scores at 6 and 12\u2009months postoperatively, as well as in terms of the Modified MacNab criteria at 12\u2009months, compared to the CMLD group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Through strategic laminectomy site selection, SILI achieves effective evacuation of epidural abscesses via hydrodynamic bidirectional irrigation, enabling sufficient intraspinal debridement. This approach significantly reduces inflammatory markers and improves neurological function postoperatively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70289","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T14:34:11Z","timestamp":1773758051000},"page":"765-776","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Application of Selective Intersegmental Laminectomy With Irrigation Technology in the Treatment of Spinal Epidural Abscess"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5842-8552","authenticated-orcid":false,"given":"Han","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopedics The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukun","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianyu","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changlin","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofan","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2921-0699","authenticated-orcid":false,"given":"Yongming","family":"Xi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"59","DOI":"10.31053\/1853.0605.v80.n1.37392","article-title":"Extensive Spinal Epidural Abscess After Nerve Root Injection in a Young Non\u2010Immunocompromised Patient. 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