This report describes treatment of concurrent epidural and
retropharyngeal abscesses and presents a novel surgical approach to treating this pathology. The treatment of epidural and retropharyngeal prevertebral
abscesses requires surgical drainage in addition to systemic
antibiotics. After the patient's airway is secured, urgent otolaryngologic surgery consultation is obtained for transoral drainage of the
retropharyngeal abscesses to minimize risk to vascular and nervous structures within the neck. If epidural extension is also present, urgent neurosurgical evaluation and
decompression may be necessary. We report a patient with an epidural and prevertebral
abscess. A posterior approach was taken for wide
decompression of the cervical spine and evacuation of the epidural collection. During this procedure, under fluoroscopic guidance, an 8 Fr soft rubber
catheter was slowly advanced ventrally in the epidural space through the C5-6 intervertebral disk into the
retropharyngeal abscess with evacuation of this collection as well. Using a single, wide posterior approach, the dorsal epidural, the ventral epidural, and prevertebral
abscesses were all successfully evacuated. This report describes a novel approach for evacuation of prevertebral
abscess concurrent with multilevel
laminectomy for
epidural abscess evacuation.