title: Oblique corpectomy for treatment of cervical spine epidural abscesses: Report on four cases.
abstract: BACKGROUND
  Spinal epidural abscesses (SEAs) in cervical locations are particularly life-threatening. Currently, SEAs are widely treated with bony decompression, followed by internal stabilization in purulent osteomyelitis. However, recently, a growing number of studies have reported minimally invasive approaches without internal fixation.
  
  
  OBJECTIVE
  We describe four patients with cervical SEAs that were evacuated by oblique corpectomy (OC) without fusion.
  
  
  METHODS
  This study included two women and two men (aged 44-90) that received operations for removing ventral cervical SEAs. All patients presented with progressively increasing myelopathy, and 3 had severe comorbid conditions. In all cases, a multilevel OC without fusion was performed. The amount of bone resection was tailored to fit the needs of granulation removal, with an effort to retain as much of the vertebral bodies as possible. Then, pus was evacuated and debridement of granulation was performed, followed by rinsing and drainage.
  
  
  RESULTS
  The neurological status of 3 patients improved significantly after surgery. At the last follow-up examination, one showed full recovery, and in two a minor residual deficit persisted. During mean follow-up of 5.5 years, no internal stabilization was necessary. The oldest patient was tetraplegic, and had several concomitant diseases. That patient died from sudden cardiac arrest on the third postoperative day. Oblique corpectomy did not affect the anterior or posterior column. Additionally, it provided a broad view of the ventral aspect of the spinal canal.
  
  
  CONCLUSIONS
  Oblique corpectomy allows appropriate spinal cord decompression and granulation removal in the case of cervical spine epidural abscess, without sacrificing spinal stability.
authors: Medical University of Warsaw, Poland.
authors: Przemysław
authors: P
authors: Kunert
authors: Medical University of Warsaw, Poland. Electronic address: mpro76@tlen.pl.
authors: Marek
authors: M
authors: Prokopienko
authors: Medical University of Warsaw, Poland.
authors: Arkadiusz
authors: A
authors: Nowak
authors: Medical University of Warsaw, Poland.
authors: Tomasz
authors: T
authors: Czernicki
authors: Medical University of Warsaw, Poland.
authors: Andrzej
authors: A
authors: Marchel
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D020802:Epidural Abscess / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011859:Radiography; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000209:etiology; D016896:Treatment Outcome
keywords: Cervical spine; Oblique corpectomy; Spinal epidural abscess