Case of unilateral biportal endoscopic management of multilevel thoracic spinal epidural abscess with acute paraplegia.

Authors

Rodolfo Guerrero-Pérez, Carlos Eduardo Granados-Maldonado, Jorge Agustín González-Almazán, María Fernanda Salas-Segura, Carlos Castillo-Rangel, Daniel Oswaldo Dávila-Rodríguez

Published in

Surgical neurology international. Volume 17. Pages 535. Epub Sep 25, 2026.

Abstract

Spinal epidural abscess (SEA) may cause rapidly progressive neurological deterioration and requires urgent decompression when severe spinal cord compression is present. Unilateral biportal endoscopy (UBE) has been increasingly applied to spinal infection, but its use for extensive thoracic SEA has rarely been reported.
A 49-year-old female with poorly controlled type 2 diabetes mellitus presented with severe thoracic back pain and the acute onset of paraplegia. Thoracic magnetic resonance demonstrated a posterior epidural abscess extending from T7 to T11 resulting in severe thoracic spinal cord compression. Urgent decompression and abscess evacuation were performed using UBE without conversion to open surgery. Postoperative imaging demonstrated near-complete evacuation of the collection, while motor strength progressively improved to Medical Research Council grade 4/5 in both lower extremities.
UBE may provide effective decompression and abscess evacuation in carefully selected patients with multilevel posterior thoracic SEA.

PMID:
42829643
Bibliographic data and abstract were imported from PubMed on 04 Oct 2026.

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