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Thoracic Spine Epidural Abscess Causing Paraplegia

Epidural Abscess and Osteomyelitis

•60 year old with paraparesis and fever denovo

•Cord compression noted on preop CT and MRI scan

Preop Sagittal CT

C8-I1

Preop Axial CT

C8-I2

Surgery

•Posterior approach

•Laminectomy

•Transpedicular corpectomy and decompression of the anterior aspect of the cord and debridement of the vertebral body

•Pack autologous iliac crest bone graft. Harvest it 1st before the spine procedure

•Posterior Fixation with postop Immobilization TLSO

•3 months of IV antibiotics Ancef following CRP and sed rate

Excellent Outcome

C8-I3