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Holospinal Epidural Abscess – A Surgical Perspective

Venugopal S and Ganapathy S

Holospinal epidural abscesses (HEAs) are exceedingly rare, with very few documented cases in the literature. It is a condition in which spinal epidural abscesses extend from the cervical to the sacral spine. Despite the increasing prevalence of spinal infections, the subcategory of HEAs is extremely infrequent and requires unique management. Holospinal imaging modern aggressive antibiotic therapy, and prompt surgical intervention remain the standard of care for all spinal axis infections including HEAs. However, the surgical decision making on timing and extent of the procedure still remain ill-defined for HEAs. We report a patient who presented with rapidly progressive quadriparesis secondary to HEA. He underwent urgent surgical decompression with abscess drainage and arrest of further neurological deterioration. We discuss the surgical management strategies and briefly review the literature regarding HEA.