1. Copyright © 2015 Lippincott Williams & Wilkins. Unauthorized commercial reproduction of this slide is prohibited Supplemental PowerPoint Slides Surgical Management in 40 Consecutive Patients with Cervical Spinal Epidural Abscesses: Shifting towards Circumferential Treatment George M. Ghobrial MD,1 MD, Matthew J. Viereck,1 Philip J. Margiotta,1 Sara Beygi MD,1 Christopher M. Maulucci MD,1 Joshua E. Heller1MD, Alexander R. Vaccaro MD, PhD3 James S. Harrop MD,1,4 1-Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107 2-Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, AZ 85003 3-Professor and Chair of Orthopedic Surgery, Department of Orthopedic Surgery, The Rothman Institute, Philadelphia, PA, 19107 4- Corresponding Author: James S. Harrop, MD, Professor of Neurological Surgery, Thomas Jefferson University Hospital

2. Cervical spinal epidural abscess management (CSEA) is guided by small case series. The authors review the largest retrospective series to date of 40 patients with cervical spondylodiscitis, with a focus on the shift from single to staged anteroposterior decompression and stabilization.

3. Results Table 1.(top left) Comorbidities of Patients Presenting with Cervical Spinal Epidural Abscesses Table 2. (top right) Neurologic and Radiographic Presentation Table 3. (bottom right) Surgical Management

4. Conclusions In this series, patients underwent acute evacuation and spinal cord decompression, and the shift towards staged treatment did not lead to an increased periprocedural complication rate. Fusion was achieved with a high rate (97.5%) and not significantly influenced by halo use in 10 patients or staged circumferential treatment. In this series, all cases underwent urgent evacuation and there were no cases of further neurologic deterioration.