LAUSR

OBJECTIVE Spinal epidural abscess is a pathology that may require prompt surgical intervention. Ventral cervical abscesses pose a particular challenge regarding the approach for surgical evacuation. The objective of this project is to describe the technical nuances of a posterior transpedicular cervical approach for the evacuation of a ventral epidural abscess MATERIAL AND METHODS: After a standard laminectomy, a foraminotomy is performed to identify the exiting nerve root. Then, the medial aspect of the pedicle below the nerve is drilled. This allows the insertion of a dissector to reach the ventral epidural space and drain the contents in conjunction with suction and irrigation. The posterolateral aspect of the superior endplate of the respective vertebra can be further drilled at this point, allowing access to the disc space with minimal retraction of the exiting nerve root. RESULTS Two patients underwent emergent evacuation of a ventral epidural abscess in the cervical spine using this technique. Radiographic and clinical improvement was evident after the evacuation of the abscesses in both cases. CONCLUSION Access to the ventral epidural space is feasible using a transpedicular approach in the cervical spine for the evacuation of an epidural abscess.