{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:19:55Z","timestamp":1792621195217,"version":"4.5.0"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:p>Spinal epidural abscess (SEA) is a rare but often devastating infection of the epidural space around the spinal cord. When an SEA is widespread, extensive decompression with laminectomy is often impossible, as it may subject the patient to very long operative times, extensive blood loss, and mechanical instability. A technique called \u201cskip laminectomy\u201d has been described in the literature, in which laminectomies are performed at the rostral and caudal ends of an abscess that spans 3\u20135 levels and a Fogarty catheter is used to mechanically drain the abscess, much like in an embolectomy. In this report of 2 patients, the authors present a modification of this technique, which they call \u201capical laminectomies\u201d to allow for irrigation and drainage of an extensive SEA spanning the entire length of the vertebral column (C1\u20132 to L5\u2013S1).<\/jats:p>\n<jats:p>Two patients presented with cervico-thoraco-lumbar SEA. Laminectomies were performed at the natural apices of the spine, namely, at the midcervical, midthoracic, and midlumbar spine levels. Next, a pediatric feeding tube was inserted in the epidural space from the thoracic laminectomies up toward the cervical laminectomy site and down toward the lumbar laminectomy site, and saline antibiotics were used to irrigate the SEA. Both patients underwent this procedure with no adverse effects. Their SEAs resolved both clinically and radiologically. Neither patient suffered from mechanical instability at 1 year after treatment.<\/jats:p>\n<jats:p>For patients who present with extensive SEAs, apical laminectomies seem to allow for surgical cure of the infectious burden and do not subject the patient to extended operating room time, an increased risk of blood loss, and the risk of mechanical instability.<\/jats:p>","DOI":"10.3171\/2014.11.spine131166","type":"journal-article","created":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T14:59:58Z","timestamp":1420210798000},"page":"318-323","source":"Crossref","is-referenced-by-count":26,"title":["Extensive spinal epidural abscess treated with \u201capical laminectomies\u201d and irrigation of the epidural space: report of 2 cases"],"prefix":"10.3171","volume":"22","author":[{"given":"Muhammad M.","family":"Abd-El-Barr","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenya Linda","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biji","family":"Bahluyen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel T.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Groff","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine131166","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1056\/NEJM197509042931001","article-title":"Spinal epidural abscess","volume":"293","author":"Baker","year":"1975"},{"key":"b2-spine131166","series-title":"Am Fam Physician","first-page":"1341","article-title":"Spinal epidural abscess: a diagnostic challenge","volume":"65","author":"Chao","year":"2002"},{"key":"b3-spine131166","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1016\/j.surneu.2004.08.081","article-title":"Spinal epidural abscess: clinical presentation, management, and outcome","volume":"63","author":"Curry","year":"2005"},{"key":"b4-spine131166","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1001\/archsurg.1926.01130100021002","article-title":"Abscesses and inflammatory tumors in the spinal epidural space (so-called pachymeningitis externa)","volume":"13","author":"Dandy","year":"1926"},{"key":"b5-spine131166","series-title":"Joint Bone Spine","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1016\/S1297-319X(02)00398-6","article-title":"Extensive primary epidural abscess. 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Case report","volume":"13","author":"Tahir","year":"2010"},{"key":"b20-spine131166","series-title":"BMC Musculoskelet Disord","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/1471-2474-9-84","article-title":"Biomechanical comparison of lumbar spine instability between laminectomy and bilateral laminotomy for spinal stenosis syndrome \u2013 an experimental study in porcine model","volume":"9","author":"Tai","year":"2008"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/22\/3\/article-p318.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/22\/3\/article-p318.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/22\/3\/article-p318.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T21:28:47Z","timestamp":1681594127000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/22\/3\/article-p318.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3]]},"references-count":20,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2014.11.spine131166","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2015,3]]}}}