Anterior Cervical Discectomy, Drainage and Non-instrumented Cortico-Cancellous Allograft Fusion: A Treatment Option for Ventral Cervical Spinal Epidural Abscess

Introduction: Ventral cervical spinal epidural abscess is a very rare clinical condition with a relatively high morbidity and mortality. Due to the paucity of reported cases there is heterogeneity and no clear “gold standard” in the treatment of these patients. Objective: The authors report four consecutive patients with ventral cervical spinal epidural abscess treated with anterior cervical discectomy, abscess drainage and original non-instrumented cortico-cancellous allograft spinal fusion. Methods: The authors retrospectively reviewed a series of four patients treated for ventral cervical epidural spinal abscess. All patients were treated with an urgent operation. Anterior cervical discectomy, abscess drainage, and non-instrumented cortico-cancellous allograft spinal fusion followed by cervical immobilization and systemic antibiotic treatment were utilized. Results: The bone fusion occurred within a mean of 3.5 months of follow-up. No significant radiologic or clinical evidence of graft subsidence was noted after a minimum of 2.5 years follow-up. All patients resolved infection and were neurologically intact. No complications of treatment were noted. Conclusion: Urgent operative treatment with anterior cervical discectomy, abscess drainage and non-instrumented cortico-cancellous allograft spinal fusion, followed by immobilization and the appropriate systemic antibiotic treatment is an effective original modification for the treatment and resolution of ventral cervical epidural spinal abscess