{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:33:25Z","timestamp":1769726005796,"version":"3.49.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"20","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,11,17]]},"abstract":"\n BACKGROUND<\/jats:title>\n The authors present the case of a patient with an extensive lumbosacral spinal epidural abscess (SEA) that was successfully evacuated in its entirety with a unilateral interlaminar approach. This is an alternative to wide bony decompression at multiple segments. The surgical approach described decompresses the neural elements while maintaining spinal integrity.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n Partial removal of the ligamentum flavum can provide an interlaminar corridor that is sufficient to evacuate extensive SEAs in select patients.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n This case illustrates a surgical approach that successfully evacuates extensive lumbosacral SEA while respecting spinal integrity.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/abs\/10.3171\/CASE25646<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25646","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:09:33Z","timestamp":1769684973000},"source":"Crossref","is-referenced-by-count":0,"title":["Extensive spinal epidural abscess evacuated with unilateral interlaminar approach (with operative video): illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"George A.","family":"Crabill","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Science Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack A.","family":"Leoni","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Science Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaleb","family":"Derouen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Science Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamieson","family":"Glasser","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Science Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wesley","family":"Shoap","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Science Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Tender","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Science Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"19","key":"bib1","series-title":"N Engl J Med","first-page":"2012","article-title":"Spinal epidural abscess","volume":"355","author":"Darouiche","year":"2006","unstructured":"Darouiche RO.Spinal epidural abscess. N Engl J Med. 2006;355(19):2012-2020."},{"key":"bib2","article-title":"Spinal epidural abscess","author":"Sexton","unstructured":"Sexton DJSampson JH.Spinal epidural abscess. UpToDate. Accessed August 19, 2025. https:\/\/www.uptodate.com\/contents\/spinal-epidural-abscess"},{"issue":"12","key":"bib3","series-title":"Am J Med","first-page":"1458","article-title":"Spinal epidural abscess: a series of 101 cases","volume":"130","author":"Vakili","year":"2017","unstructured":"Vakili MCrum-Cianflone NF.Spinal epidural abscess: a series of 101 cases. Am J Med. 2017;130(12):1458-1463."},{"issue":"1","key":"bib4","series-title":"QJM","first-page":"1","article-title":"Spinal epidural abscess in clinical practice","volume":"101","author":"Sendi","year":"2008","unstructured":"Sendi PBregenzer TZimmerli W.Spinal epidural abscess in clinical practice. QJM. 2008;101(1):1-12."},{"key":"bib5","article-title":"Spinal epidural abscess","author":"Ameer","unstructured":"Ameer MAMunakomi SMesfin FB.Spinal epidural abscess. In: StatPearls. StatPearls Publishing; 2025. Accessed August 19, 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK441890\/"},{"issue":"6","key":"bib6","series-title":"Clin Infect Dis","first-page":"e26","article-title":"Infectious Diseases Society of America clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults","volume":"61","author":"Berbari","year":"2015","unstructured":"Berbari EFKanj SSKowalski TJInfectious Diseases Society of America clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults. Clin Infect Dis. 2015;61(6):e26-e46."},{"issue":"2","key":"bib7","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Medical and surgical management of spinal epidural abscess: a systematic review","volume":"37","year":"2014","unstructured":"ArkoL 4thQuachENguyenVChangDSukulVKimBS. Medical and surgical management of spinal epidural abscess: a systematic review. Neurosurg Focus. 2014;37(2):E4."},{"key":"bib8","series-title":"World Neurosurg","first-page":"111","article-title":"Minimally invasive surgical treatment of extensive spinal epidural abscess with unilateral laminotomy for bilateral decompression using an ultrasonic bone curette: a technique note","volume":"168","author":"Lee","year":"2022","unstructured":"Lee CYChen PCWu MHMinimally invasive surgical treatment of extensive spinal epidural abscess with unilateral laminotomy for bilateral decompression using an ultrasonic bone curette: a technique note. World Neurosurg. 2022;168:111-119."},{"issue":"4","key":"bib9","series-title":"J Spine Surg","first-page":"729","article-title":"Tailored minimally invasive tubular laminectomies for the urgent treatment of rare holocord spinal epidural abscess: case report and review of technique","volume":"6","author":"Roberti","year":"2020","unstructured":"Roberti F.Tailored minimally invasive tubular laminectomies for the urgent treatment of rare holocord spinal epidural abscess: case report and review of technique. J Spine Surg. 2020;6(4):729-735."},{"issue":"10","key":"bib10","series-title":"Cureus","first-page":"e30437","article-title":"The surgical management of holospinal epidural abscess: a case report and review on catheter-based irrigation techniques","volume":"14","author":"Halalmeh","year":"2022","unstructured":"Halalmeh DRPage JChilders CMoisi MD.The surgical management of holospinal epidural abscess: a case report and review on catheter-based irrigation techniques. Cureus. 2022;14(10):e30437."},{"issue":"5","key":"bib11","series-title":"Asian Spine J","first-page":"742","article-title":"Spinal epidural abscess: a review of presentation, management, and medicolegal implications","volume":"14","author":"Sharfman","year":"2020","unstructured":"Sharfman ZTGelfand YShah PSpinal epidural abscess: a review of presentation, management, and medicolegal implications. Asian Spine J. 2020;14(5):742-759."},{"issue":"4","key":"bib12","series-title":"Open Forum Infect Dis","first-page":"ofw191","article-title":"Spinal epidural abscess in adults: a 10-year clinical experience at a tertiary care academic medical center","volume":"3","author":"Artenstein","year":"2016","unstructured":"Artenstein AWFriderici JHolers ALewis DFitzgerald JVisintainer P.Spinal epidural abscess in adults: a 10-year clinical experience at a tertiary care academic medical center. Open Forum Infect Dis. 2016;3(4):ofw191."},{"issue":"1","key":"bib13","series-title":"J Neurosurg Spine","first-page":"81","article-title":"Incidence and risk factors for failed medical management of spinal epidural abscess: a systematic review and meta-analysis","volume":"26","author":"Stratton","year":"2017","unstructured":"Stratton AGustafson KThomas KJames MT.Incidence and risk factors for failed medical management of spinal epidural abscess: a systematic review and meta-analysis. J Neurosurg Spine. 2017;26(1):81-89."},{"issue":"2","key":"bib14","series-title":"Spine J","first-page":"326","article-title":"Spinal epidural abscesses: risk factors, medical versus surgical management, a retrospective review of 128 cases","volume":"14","author":"Patel","year":"2014","unstructured":"Patel ARAlton TBBransford RJLee MJBellabarba CBChapman JR.Spinal epidural abscesses: risk factors, medical versus surgical management, a retrospective review of 128 cases. Spine J. 2014;14(2):326-330."},{"issue":"3","key":"bib15","series-title":"J Neurosurg Spine","first-page":"318","article-title":"Extensive spinal epidural abscess treated with \u201capical laminectomies\u201d and irrigation of the epidural space: report of 2 cases","volume":"22","author":"Abd-El-Barr","year":"2015","unstructured":"Abd-El-Barr MMBi WLBahluyen BRodriguez STGroff MWChi JH.Extensive spinal epidural abscess treated with \u201capical laminectomies\u201d and irrigation of the epidural space: report of 2 cases. J Neurosurg Spine. 2015;22(3):318-323."},{"key":"bib16","series-title":"World Neurosurg","first-page":"e383","article-title":"Iatrogenic spondylolisthesis following open lumbar laminectomy: case series and review of the literature","volume":"113","author":"Ramhmdani","year":"2018","unstructured":"Ramhmdani SXia YXu RIatrogenic spondylolisthesis following open lumbar laminectomy: case series and review of the literature. World Neurosurg. 2018;113:e383-e390."},{"issue":"4","key":"bib17","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts","volume":"39","author":"Guha","year":"2015","unstructured":"Guha DHeary RFShamji MF.Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts. Neurosurg Focus. 2015;39(4):E9."},{"issue":"7","key":"bib18","series-title":"J Bone Joint Surg Am","first-page":"546","article-title":"Nonoperative management of spinal epidural abscess: development of a predictive algorithm for failure","volume":"100","author":"Shah","year":"2018","unstructured":"Shah AAOgink PTNelson SBHarris MBSchwab JH.Nonoperative management of spinal epidural abscess: development of a predictive algorithm for failure. J Bone Joint Surg Am. 2018;100(7):546-555."},{"issue":"11","key":"bib19","series-title":"Bioengineering (Basel)","first-page":"614","article-title":"Negative pressure wound therapy in spinal surgery","volume":"9","author":"White","year":"2022","unstructured":"White AJGilad RMotivala SFiani BRasouli J.Negative pressure wound therapy in spinal surgery. Bioengineering (Basel). 2022;9(11):614."},{"issue":"3","key":"bib20","series-title":"J Neurosurg Spine","first-page":"430","article-title":"Use of incisional vacuum-assisted closure in the prevention of postoperative infection in high-risk patients who underwent spine surgery: a proof-of-concept study","volume":"31","author":"Dyck","year":"2019","unstructured":"Dyck BABailey CSSteyn CUse of incisional vacuum-assisted closure in the prevention of postoperative infection in high-risk patients who underwent spine surgery: a proof-of-concept study. J Neurosurg Spine. 2019;31(3):430-439."},{"issue":"19","key":"bib1","series-title":"N Engl J Med","first-page":"2012","article-title":"Spinal epidural abscess","volume":"355","author":"Darouiche","year":"2006","unstructured":"Darouiche RO.Spinal epidural abscess. N Engl J Med. 2006;355(19):2012-2020."},{"key":"bib2","article-title":"Spinal epidural abscess","author":"Sexton","unstructured":"Sexton DJSampson JH.Spinal epidural abscess. UpToDate. Accessed August 19, 2025. https:\/\/www.uptodate.com\/contents\/spinal-epidural-abscess"},{"issue":"12","key":"bib3","series-title":"Am J Med","first-page":"1458","article-title":"Spinal epidural abscess: a series of 101 cases","volume":"130","author":"Vakili","year":"2017","unstructured":"Vakili MCrum-Cianflone NF.Spinal epidural abscess: a series of 101 cases. Am J Med. 2017;130(12):1458-1463."},{"issue":"1","key":"bib4","series-title":"QJM","first-page":"1","article-title":"Spinal epidural abscess in clinical practice","volume":"101","author":"Sendi","year":"2008","unstructured":"Sendi PBregenzer TZimmerli W.Spinal epidural abscess in clinical practice. QJM. 2008;101(1):1-12."},{"key":"bib5","article-title":"Spinal epidural abscess","author":"Ameer","unstructured":"Ameer MAMunakomi SMesfin FB.Spinal epidural abscess. In: StatPearls. StatPearls Publishing; 2025. Accessed August 19, 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK441890\/"},{"issue":"6","key":"bib6","series-title":"Clin Infect Dis","first-page":"e26","article-title":"Infectious Diseases Society of America clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults","volume":"61","author":"Berbari","year":"2015","unstructured":"Berbari EFKanj SSKowalski TJInfectious Diseases Society of America clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults. Clin Infect Dis. 2015;61(6):e26-e46."},{"issue":"2","key":"bib7","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Medical and surgical management of spinal epidural abscess: a systematic review","volume":"37","year":"2014","unstructured":"ArkoL 4thQuachENguyenVChangDSukulVKimBS. Medical and surgical management of spinal epidural abscess: a systematic review. Neurosurg Focus. 2014;37(2):E4."},{"key":"bib8","series-title":"World Neurosurg","first-page":"111","article-title":"Minimally invasive surgical treatment of extensive spinal epidural abscess with unilateral laminotomy for bilateral decompression using an ultrasonic bone curette: a technique note","volume":"168","author":"Lee","year":"2022","unstructured":"Lee CYChen PCWu MHMinimally invasive surgical treatment of extensive spinal epidural abscess with unilateral laminotomy for bilateral decompression using an ultrasonic bone curette: a technique note. World Neurosurg. 2022;168:111-119."},{"issue":"4","key":"bib9","series-title":"J Spine Surg","first-page":"729","article-title":"Tailored minimally invasive tubular laminectomies for the urgent treatment of rare holocord spinal epidural abscess: case report and review of technique","volume":"6","author":"Roberti","year":"2020","unstructured":"Roberti F.Tailored minimally invasive tubular laminectomies for the urgent treatment of rare holocord spinal epidural abscess: case report and review of technique. J Spine Surg. 2020;6(4):729-735."},{"issue":"10","key":"bib10","series-title":"Cureus","first-page":"e30437","article-title":"The surgical management of holospinal epidural abscess: a case report and review on catheter-based irrigation techniques","volume":"14","author":"Halalmeh","year":"2022","unstructured":"Halalmeh DRPage JChilders CMoisi MD.The surgical management of holospinal epidural abscess: a case report and review on catheter-based irrigation techniques. Cureus. 2022;14(10):e30437."},{"issue":"5","key":"bib11","series-title":"Asian Spine J","first-page":"742","article-title":"Spinal epidural abscess: a review of presentation, management, and medicolegal implications","volume":"14","author":"Sharfman","year":"2020","unstructured":"Sharfman ZTGelfand YShah PSpinal epidural abscess: a review of presentation, management, and medicolegal implications. Asian Spine J. 2020;14(5):742-759."},{"issue":"4","key":"bib12","series-title":"Open Forum Infect Dis","first-page":"ofw191","article-title":"Spinal epidural abscess in adults: a 10-year clinical experience at a tertiary care academic medical center","volume":"3","author":"Artenstein","year":"2016","unstructured":"Artenstein AWFriderici JHolers ALewis DFitzgerald JVisintainer P.Spinal epidural abscess in adults: a 10-year clinical experience at a tertiary care academic medical center. Open Forum Infect Dis. 2016;3(4):ofw191."},{"issue":"1","key":"bib13","series-title":"J Neurosurg Spine","first-page":"81","article-title":"Incidence and risk factors for failed medical management of spinal epidural abscess: a systematic review and meta-analysis","volume":"26","author":"Stratton","year":"2017","unstructured":"Stratton AGustafson KThomas KJames MT.Incidence and risk factors for failed medical management of spinal epidural abscess: a systematic review and meta-analysis. J Neurosurg Spine. 2017;26(1):81-89."},{"issue":"2","key":"bib14","series-title":"Spine J","first-page":"326","article-title":"Spinal epidural abscesses: risk factors, medical versus surgical management, a retrospective review of 128 cases","volume":"14","author":"Patel","year":"2014","unstructured":"Patel ARAlton TBBransford RJLee MJBellabarba CBChapman JR.Spinal epidural abscesses: risk factors, medical versus surgical management, a retrospective review of 128 cases. Spine J. 2014;14(2):326-330."},{"issue":"3","key":"bib15","series-title":"J Neurosurg Spine","first-page":"318","article-title":"Extensive spinal epidural abscess treated with \u201capical laminectomies\u201d and irrigation of the epidural space: report of 2 cases","volume":"22","author":"Abd-El-Barr","year":"2015","unstructured":"Abd-El-Barr MMBi WLBahluyen BRodriguez STGroff MWChi JH.Extensive spinal epidural abscess treated with \u201capical laminectomies\u201d and irrigation of the epidural space: report of 2 cases. J Neurosurg Spine. 2015;22(3):318-323."},{"key":"bib16","series-title":"World Neurosurg","first-page":"e383","article-title":"Iatrogenic spondylolisthesis following open lumbar laminectomy: case series and review of the literature","volume":"113","author":"Ramhmdani","year":"2018","unstructured":"Ramhmdani SXia YXu RIatrogenic spondylolisthesis following open lumbar laminectomy: case series and review of the literature. World Neurosurg. 2018;113:e383-e390."},{"issue":"4","key":"bib17","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts","volume":"39","author":"Guha","year":"2015","unstructured":"Guha DHeary RFShamji MF.Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts. Neurosurg Focus. 2015;39(4):E9."},{"issue":"7","key":"bib18","series-title":"J Bone Joint Surg Am","first-page":"546","article-title":"Nonoperative management of spinal epidural abscess: development of a predictive algorithm for failure","volume":"100","author":"Shah","year":"2018","unstructured":"Shah AAOgink PTNelson SBHarris MBSchwab JH.Nonoperative management of spinal epidural abscess: development of a predictive algorithm for failure. J Bone Joint Surg Am. 2018;100(7):546-555."},{"issue":"11","key":"bib19","series-title":"Bioengineering (Basel)","first-page":"614","article-title":"Negative pressure wound therapy in spinal surgery","volume":"9","author":"White","year":"2022","unstructured":"White AJGilad RMotivala SFiani BRasouli J.Negative pressure wound therapy in spinal surgery. Bioengineering (Basel). 2022;9(11):614."},{"issue":"3","key":"bib20","series-title":"J Neurosurg Spine","first-page":"430","article-title":"Use of incisional vacuum-assisted closure in the prevention of postoperative infection in high-risk patients who underwent spine surgery: a proof-of-concept study","volume":"31","author":"Dyck","year":"2019","unstructured":"Dyck BABailey CSSteyn CUse of incisional vacuum-assisted closure in the prevention of postoperative infection in high-risk patients who underwent spine surgery: a proof-of-concept study. 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