Asian Spine Journal (Aug 2015)

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

  • Jason Pui Yin Cheung,
  • Kin Cheung Mak,
  • Helen Hoi Lun Tsang,
  • Keith Dip Kei Luk

DOI
https://doi.org/10.4184/asj.2015.9.4.617
Journal volume & issue
Vol. 9, no. 4
pp. 617 – 620

Abstract

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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.

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