Extensive spinal epidural abscess evacuated with unilateral interlaminar approach (with operative video): illustrative case

BACKGROUND: The authors present the case of a patient with an extensive lumbosacral spinal epidural abscess (SEA) that was successfully evacuated in its entirety with a unilateral interlaminar approach. This is an alternative to wide bony decompression at multiple segments. The surgical approach described decompresses the neural elements while maintaining spinal integrity. OBSERVATIONS: Partial removal of the ligamentum flavum can provide an interlaminar corridor that is sufficient to evacuate extensive SEAs in select patients. LESSONS: This case illustrates a surgical approach that successfully evacuates extensive lumbosacral SEA while respecting spinal integrity. https://thejns.org/doi/abs/10.3171/CASE25646.