Clinical efficacy of intervertebral foraminoscopic debridement with catheter drainage for lumbar spinal epidural abscess

OBJECTIVES: To evaluate the clinical efficacy of percutaneous transforaminal endoscopic debridement with catheter drainage for the treatment of single-segment lumbar spinal epidural abscess (SEA). METHODS: We retrospectively analysed clinical data from 12 patients with nonspecific single-segment spinal epidural abscess who underwent percutaneous transforaminal endoscopy at our hospital between March 2019 and June 2023. Intraoperative lesion tissue was subjected to microbial culture and histopathological examination. Postoperative anti-infection treatment was given based on drug sensitivity and clinical response. Postoperative CT/MRI was performed to evaluate abscess clearance. WBC, CRP, and ESR levels were measured before and after surgery, and the degree of symptom relief was evaluated using the VAS, ODI, and MacNab criteria. Dynamic radiographs were obtained to evaluate spinal stability, and imaging data were reviewed to assess infection recurrence. RESULTS: All patients successfully underwent surgery without postoperative complications. Various indicators improved significantly at 1 week, 1 month, and 3 months after surgery, as well as at the last follow-up, compared with preoperative levels (P < 0.05). Clinical symptoms improved significantly. According to MacNab criteria, the excellent and good rate was 91.7%. Two patients (16.7%) underwent lumbar fusion surgery due to new neurological symptoms in both legs after 3 months. In the remaining patients, infectious symptoms improved, and no recurrence occurred during the follow-up period. CONCLUSIONS: Percutaneous transforaminal endoscopic debridement with catheter drainage is a valuable and minimally invasive surgical approach for the treatment of SEA with preliminary feasibility and safety under certain conditions.