Severe Midline Lower Back in Surgery — Case | Neurosurgery | SMLE Q#17068

SMLE Question #17068

Surgery Neurosurgery

Objective: OBJ-310

Last updated: February 2026
A 26-year-old primigravida had a forceps-assisted vaginal delivery under epidural anesthesia. Ten days postpartum, she presents with severe midline lower back pain, fever, and difficulty walking. Examination shows localized lumbar spine tenderness and mild weakness in both lower limbs. MRI of the spine shows an epidural collection at the prior epidural insertion level with thecal sac compression. What is the most appropriate next step in management?

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