Asian Spine J.  2015 Aug;9(4):617-620. 10.4184/asj.2015.9.4.617.

A Lethal Sequelae of Spinal Infection Complicating Surgery and Radiotherapy for Head and Neck Cancer

• Cheung JP
• Mak KC
• Tsang HH
• Luk KD

• KMID: 2169336
• DOI: http://doi.org/10.4184/asj.2015.9.4.617

Abstract

Patients who have undergone neck dissection and radiotherapy are at risk of cervical spine infections. Furthermore, previous radiotherapy and cervical spine infections can lead to fistula formation to the subarachnoid space and intracranial infection. This report discusses the serious consequences of a missed cervical spine infection including cerebrospinal fluid fistula formation and persistent central nervous system infection, and serves as a reminder to clinicians of the possible association between cervical spine infections and prior head and neck surgery and radiotherapy. In all such cases, the posterior pharyngeal wall should be inspected during follow-up. Despite the appearance of an intracranial infection, the cervical spine should be investigated, especially if the response to appropriate antibiotics is suboptimal.

Keyword

Spondylodiscitis; Radiotherapy; Cervical spine; Cerebrospinal fluid fistula

MeSH Terms

Anti-Bacterial Agents
Central Nervous System Infections
Cerebrospinal Fluid
Discitis
Fistula
Follow-Up Studies
Head
Head and Neck Neoplasms*
Humans
Neck
Neck Dissection
Radiotherapy*
Spine
Subarachnoid Space
Anti-Bacterial Agents