Our Summary

This research paper discusses a rare and serious condition called an extensive spinal epidural abscess, which can cause serious health problems and even death. The authors describe two cases where they successfully treated this condition using a less invasive surgical technique. This technique involves creating small openings in the spine and using a catheter to drain the abscess. The authors report that this procedure effectively relieved pressure on the spinal cord, identified the bacteria causing the infection, and removed the abscess. They observed no complications or negative effects in the patients who underwent this procedure. The authors conclude that immediate surgery, combined with long-term antibiotics, is typically the best treatment for extensive spinal abscesses, and that this less invasive procedure can be a good surgical option.

FAQs

  1. What is an extensive spinal epidural abscess and what health problems can it cause?
  2. What is the less invasive surgical technique used to treat this condition and how is it performed?
  3. What are the benefits of this less invasive procedure and are there any reported complications or negative effects?

Doctor’s Tip

A doctor may advise a patient undergoing spinal laminectomy to follow post-operative care instructions carefully, including taking prescribed pain medications, attending physical therapy sessions, and avoiding heavy lifting or strenuous activities for a certain period of time. They may also recommend maintaining a healthy weight, practicing good posture, and engaging in regular exercise to support the healing process and prevent future issues with the spine.

Suitable For

Patients who are typically recommended spinal laminectomy include those with spinal stenosis, herniated discs, or spinal tumors that are causing compression of the spinal cord or nerves. In the case of spinal epidural abscess, patients with extensive abscesses that are causing neurological symptoms such as severe back pain, weakness, numbness, or difficulty walking may be recommended for a spinal laminectomy to relieve pressure on the spinal cord and nerves. Additionally, patients who have not responded to conservative treatments such as antibiotics or steroid injections may also be candidates for spinal laminectomy.

Timeline

Before spinal laminectomy:

  1. Patient may experience symptoms such as back pain, leg pain, numbness, tingling, weakness, and difficulty walking.
  2. Patient undergoes diagnostic tests such as X-rays, MRI, and CT scans to determine the extent of the spinal condition.
  3. Patient may undergo conservative treatments such as physical therapy, medication, and injections to manage symptoms.
  4. If conservative treatments are not effective, patient may be recommended for spinal laminectomy surgery.

After spinal laminectomy:

  1. Patient undergoes pre-operative evaluations and tests to ensure readiness for surgery.
  2. Patient undergoes spinal laminectomy surgery, where the lamina (back part of the vertebrae) is removed to relieve pressure on the spinal cord or nerves.
  3. Patient stays in the hospital for a few days for monitoring and recovery.
  4. Patient may experience pain and discomfort post-surgery, which is managed with pain medication.
  5. Patient undergoes physical therapy and rehabilitation to regain strength and mobility.
  6. Patient follows up with their healthcare provider for post-operative care and monitoring of recovery progress.

What to Ask Your Doctor

  1. What is a spinal laminectomy and how does it differ from other spinal surgeries?
  2. What are the potential risks and complications associated with a spinal laminectomy?
  3. How long is the recovery period after a spinal laminectomy and what can I expect during this time?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. Are there any alternative treatments or less invasive options for my condition?
  6. How successful is a spinal laminectomy in relieving symptoms and improving overall quality of life?
  7. What is the long-term outlook for someone who undergoes a spinal laminectomy?
  8. How many of these procedures have you performed and what is your success rate?
  9. Are there any lifestyle changes or precautions I should take after the surgery to prevent complications or further damage to my spine?
  10. How soon after the surgery can I expect to see improvement in my symptoms?

Reference

Authors: Proietti L, Ricciardi L, Noia G, Barone G, Valenzi E, Perna A, Giannelli I, Scaramuzzo L, Visocchi M, Papacci F, Tamburrelli FC. Journal: Acta Neurochir Suppl. 2019;125:345-353. doi: 10.1007/978-3-319-62515-7_50. PMID: 30610344