Fujioka Masaki, Oka Kiyoshi, Kitamura Riko, Yakabe Aya
Department of Plastic and Reconstructive Surgery, National Hospital organization Nagasaki Medical Center, Nagasaki, Japan.
Surg Neurol. 2009 Dec;72(6):761-4; discussion 764. doi: 10.1016/j.surneu.2009.05.023. Epub 2009 Aug 7.
Spinal osteomyelitis and epidural abscess are uncommon but have a potentially disastrous outcome, although the surgical techniques and antimicrobial therapy have advanced.
We present a case of cervical osteomyelitis and epidural abscess resulting from pharyngeal squamous cell carcinoma ablation, which were treated with a pectoralis major muscle flap successfully.
Muscle flap insertion to the cervical contaminated wound enables radical removal of the contaminated tissue, and the muscle flaps for dead-space obliteration and neovasculation were obligatory for successful management of the infected complex wound. Furthermore, the inserted pectoralis major muscle flap can divide vertebrae and epidural canal from these origins of infection. We believe that this technique is simple, can be performed in a one-stage management, has minimal associated morbidity, and thus, is advocated as a desirable treatment option in the treatment of cervical osteomyelitis and epidural abscess.
脊髓骨髓炎和硬膜外脓肿虽不常见，但尽管手术技术和抗菌治疗有所进步，其后果仍可能是灾难性的。
我们报告一例因咽鳞状细胞癌消融导致的颈椎骨髓炎和硬膜外脓肿病例，该病例成功接受了胸大肌肌瓣治疗。
将肌瓣植入颈部污染伤口可彻底清除污染组织，用于消灭死腔和新生血管形成的肌瓣对于成功处理感染的复杂伤口必不可少。此外，植入的胸大肌肌瓣可将椎体和硬膜外腔与这些感染源分隔开。我们认为该技术操作简单，可一期完成，相关发病率极低，因此，主张将其作为治疗颈椎骨髓炎和硬膜外脓肿的理想治疗选择。
