Holospinal
epidural abscess (HEA) is an extremely rare spinal
infection involving the entire spine and is infrequently reported in the literature. Cases with evidence of
spinal cord compression and consequent neurological deficit are typically managed with prompt surgical drainage and broad-spectrum
antibiotics. Surgical intervention is often challenging because this condition is inherently associated with poor prognosis and serious complications, including death. During the surgical evacuation of the
abscess,
catheter-based irrigation must be adequately performed. In the majority of reported cases, the extent of the advancement of the epidural
catheter is blindly assessed by the operating surgeon, increasing the risk of residual collections and subsequent
persistent infection. Herein, we report a rare case of HEA that was successfully treated with surgical evacuation and skip
laminectomies. We also describe a
catheter-based technique that facilitates adequate irrigation, thereby ensuring the complete drainage of HEA in obscured perispinal areas, as well as the
decompression of the spinal cord. Postoperative neurological examination exhibited marked improvement in motor function (compared with a baseline of complete
quadriparesis), indicating the successful
decompression of the spinal cord and neurological improvement.