LAUSR

BACKGROUND No formalized surgical treatment strategy exists for a thoracic epidural abscess. While endoscopic approaches have been described for the treatment of spinal infections, this is the first report of an endoscopic transforaminal approach for the drainage of a thoracic/lumbar epidural abscess with placement of indwelling abscess drain. OBJECTIVE The authors present a novel use of a known endoscopic approach and describe a minimally invasive surgical option for ventrally located thoracic epidural abscesses. METHODS A patient with ventrally located thoracic five to lumbar five epidural abscess with cord compression was taken for an endoscopic transforaminal drainage at the right thoracic nine to thoracic ten level. A drain was left in the abscess cavity and tunneled subcutaneously for continued postoperative drainage. RESULTS Immediate postoperative radiographic results showed significant reduction in the abscess size. The patient tolerated the procedure well with return to her neurologic baseline. CONCLUSION Endoscopic transforaminal drainage of ventrally located thoracic epidural abscess is a safe procedure that may be an option for patients with a purulent filled abscess. This procedure should be considered an option so as to avoid more invasive procedures that would require decompression and possibly instrumented fusion.