Salmonella spondylodiscitis and epidural abscess successfully treated with unilateral biportal endoscopic discectomy and debridement: a rare case report

Spinal epidural abscess (SEA) is a rare but severe infection with potentially devastating consequences. Epidural abscesses caused by Salmonella serogroup C2 are even rarer and tend to be more invasive with multidrug resistance. Early diagnosis, effective use of antibiotics and surgical intervention are the mainstay strategies for managing SEA, especially for more virulent and multidrug-resistant Salmonella infections. This case report presents a rare case of an elderly and fragile woman with Salmonella spondylodiscitis and an extensive epidural abscess, which were successfully treated with intravenous antibiotics and unilateral biportal endoscopic (UBE) debridement and drainage through four small surgical incisions. After surgery, her fever subsided, she regained consciousness and her low back pain dramatically improved. Follow-up magnetic resonance imaging showed complete resolution of the epidural abscess. At 6 months after surgery, the patient regained muscle strength, ambulated with a walker and had no recurrence of the infection. The UBE technique can effectively eradicate infection while minimizing surgery-related risks and complications. A multidisciplinary team is required to achieve a good outcome.