• Aakash Chauhan, Robert J Moraca, and Daniel T Altman.
• Department of Orthopaedics, Allegheny General Hospital, Pittsburgh, PA 15212, USA.
• Spine. 2013 Jul 15;38(16):E1048-50.

Study DesignCase report.ObjectiveTo present the first reported case of using extracorporeal membrane oxygenation (ECMO) support in an emergent decompression and evacuation of a thoracic epidural abscess.Summary Of Background DataThoracic epidural abscesses with neurological deficits require surgical evaluation and intervention in most cases. We report a case of a 35-year-old patient with an acute onset of paraplegia diagnosed with a thoracic epidural abscess. The patient was emergently taken to the operating room and was unable to tolerate prone positioning secondary to cardiopulmonary collapse. ECMO was initiated for cardiopulmonary support to complete the case.MethodsRetrospective chart review of patient case.ResultsThe patient was stabilized with ECMO support and tolerated a T4-T8 laminectomy and decompression. The source of the patients abscess was hematogenous and at 6 months of clinical follow-up, the patient has no motor or sensory function of his bilateral lower extremities.ConclusionThe use of ECMO support in adult spinal surgery has not been previously reported in the literature. Therefore we describe the first reported use of ECMO to maintain cardiopulmonary support in a patient unable to tolerate prone positioning during spine surgery. ECMO support can be a viable option in adult patients who need emergent spinal surgery but are unable to tolerate prone positioning secondary to cardiopulmonary complications.

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