Delayed Cervical Epidural Abscess after Instrumentation

Abstract

We report a case of cervical epidural abscess occurring four years after instrumentation. This 70-year-old female patient visited due to sudden right hemiparesis for a week. She had undergone a sublaminar wiring with a rod from the atlas to C4 for unstable C2 and C3 body fracture, about four years ago. On admission, she had neither fever nor febrile episodes. Computed tomography of the cervical spine suggested a protruded wire into the right side of the spinal canal at C3 level. On the operation, there was an epidural abscess by Staphylococcus aureus around the atlas and the axis. After removal of the instrumentation and the lesion, the hemiparesis was resolved. Although it is rare and difficult to diagnose, delayed symptoms in patients who underwent instrumentation arouses suspicion of spinal epidural abscess.