{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T17:39:38Z","timestamp":1767721178860,"version":"3.48.0"},"reference-count":16,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,14]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Spinal epidural abscess (SEA) is a serious infection of the central nervous system that typically presents with midline back pain, fever and neurological deficits. We report a rare case of an extensive SEA extending from C2 to S1. The patient presented with neck pain, fever and progressive neurological deficits. MRI revealed a long-segment epidural abscess spanning the cervical, thoracic, lumbar and sacral spine. Surgical intervention involved posterior spinal instrumentation and fusion from C6 to T8. Intraoperatively, solidified abscess material was found encasing the spinal canal between C6 and T8, along with 7\u2009cc of liquefied pus. The patient demonstrated good neurological recovery and was discharged 1\u2009month postoperatively.<\/jats:p>","DOI":"10.1136\/bcr-2025-266473","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T17:35:18Z","timestamp":1767720918000},"page":"e266473","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Operative management of an extensive spinal epidural abscess"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4915-3051","authenticated-orcid":false,"given":"Choong Hoon","family":"Foo","sequence":"first","affiliation":[{"name":"Orthopaedic Department, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khin Maung","family":"Ohn","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tze Yang","family":"Ng","sequence":"additional","affiliation":[{"name":"Orthopaedic, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoari","family":"Krishnan","sequence":"additional","affiliation":[{"name":"KPJ Sabah Specialist Hospital, Kota Kinabalu, Sabah, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"2026010609350710000_19.1.e266473.1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00011954"},{"key":"2026010609350710000_19.1.e266473.2","doi-asserted-by":"crossref","DOI":"10.3171\/2014.6.FOCUS14261","article-title":"The indications and timing for operative management of spinal epidural abscess: literature review and treatment algorithm","volume":"37","author":"Tuchman","year":"2014","journal-title":"Neurosurg Focus"},{"key":"2026010609350710000_19.1.e266473.3","doi-asserted-by":"publisher","DOI":"10.1016\/0090-3019(92)90152-D"},{"key":"2026010609350710000_19.1.e266473.4","doi-asserted-by":"crossref","DOI":"10.3171\/foc.2004.17.6.12","article-title":"Spinal epidural abscess: appearance on magnetic resonance imaging as a guide to surgical management. Report of five cases","volume":"17","author":"Parkinson","year":"2004","journal-title":"Neurosurg Focus"},{"key":"2026010609350710000_19.1.e266473.5","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1053\/j.ro.2006.07.008","article-title":"Imaging of spinal infections","volume":"41","author":"Lury","year":"2006","journal-title":"Semin Roentgenol"},{"key":"2026010609350710000_19.1.e266473.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra055111"},{"key":"2026010609350710000_19.1.e266473.7","article-title":"Challenges in diagnosis of spinal epidural abscess","volume":"98","author":"Yang","year":"2019","journal-title":"Medicine (Abingdon)"},{"key":"2026010609350710000_19.1.e266473.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197509042931001"},{"key":"2026010609350710000_19.1.e266473.9","first-page":"381","article-title":"An extensive epidural abscess of cervicothoracic spine resolved by a combined approach: A case report","volume":"75","author":"\u0160r\u00e1mek","year":"2012","journal-title":"Cesk Slov Neurol N"},{"key":"2026010609350710000_19.1.e266473.10","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s40846-020-00579-8","article-title":"The Biomechanical Response of the Lower Cervical Spine Post Laminectomy: Geometrically-Parametric Patient-Specific Finite Element Analyses","volume":"41","author":"Nikkhoo","year":"2021","journal-title":"J Med Biol Eng"},{"key":"2026010609350710000_19.1.e266473.11","doi-asserted-by":"crossref","first-page":"278","DOI":"10.3171\/spi.2006.4.4.278","article-title":"Regional instability following cervicothoracic junction surgery","volume":"4","author":"Steinmetz","year":"2006","journal-title":"J Neurosurg Spine"},{"key":"2026010609350710000_19.1.e266473.12","doi-asserted-by":"publisher","DOI":"10.1080\/17453670810016678"},{"key":"2026010609350710000_19.1.e266473.13","doi-asserted-by":"publisher","DOI":"10.14444\/8178"},{"key":"2026010609350710000_19.1.e266473.14","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.wneu.2024.06.073","article-title":"Extensive Spinal Epidural Abscess: A Systematic Review of Risk Factors, Clinical Presentation, and Management with a Case Illustration","volume":"189","author":"Hugues Dokponou","year":"2024","journal-title":"World Neurosurg"},{"key":"2026010609350710000_19.1.e266473.15","unstructured":"Ministry of Health Malaysia . Malaysia antibiotic guideline practice 2024. Ministry of Health; 2024. Available: https:\/\/pharmacy.moh.gov.my\/en\/documents\/national-antimicrobial-guideline-nag-2024-4th-edition.html?utm_source=chatgpt.com"},{"key":"2026010609350710000_19.1.e266473.16","unstructured":"National antibiotic resistance surveillance report. 2024. Available: https:\/\/library.nih.gov.my\/e-doc\/flipbook\/imr\/nsar2024\/index"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-266473","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T17:35:20Z","timestamp":1767720920000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-266473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,6]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bcr-2025-266473"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-266473","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}