Spinal cervical infection: a case report and current update.

Abstract

Cervical spine infection is a term used to encompass osteomyelitis, discitis and epidural abscess. Most cases are caused by Staphylococcus aureus but other organisms have been isolated. The most frequent source is hematogenous spread from a nearby or distant source. Diagnosis is often confusing. The most common symptom is worsening back or neck pain that increases with movement. Patients may have motor or sensory changes if there is compression of the nerve roots or spinal cord. If the condition is not treated promptly, it may progress to irreversible neurologic deficit. Positive blood cultures and an elevated erythrocyte sedimentation rate (ESR) may be seen. Radiologic findings may include a paravertebral swelling, a destruction of the vertebral end plates and adjacent portions of the bodies and disc space and the presence of an epidural mass. Treatment includes radical surgical intervention for debridement and decompression to stabilize the spine in conjunction with 8-12 weeks of intravenous antibiotics. Closed continuous local antibiotic irrigation with a gravity control outflow system has been used.