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颈椎椎体次全切除融合术后源自牙源性的反复性颈前伤口脓肿,酷似食管穿孔:一例报告

Recurrent anterior cervical wound abscesses following cervical corpectomy and fusion surgery from an odontogenic source mimicking an esophageal perforation: a case report.

作者信息

Pan Tiffany J, Neral Mithun, Gordon Zachary, Kang James D

机构信息

University of Pittsburgh Medical Center, Department of Orthopaedic Surgery, 3471 Fifth Avenue, Pittsburgh, PA 15213.

University Hospitals/Case Medical Center, 11100 Euclid Ave, Cleveland, OH 44106.

出版信息

Spine J. 2016 Jun;16(6):e399-402. doi: 10.1016/j.spinee.2015.09.025. Epub 2015 Sep 16.

Abstract

CONTEXT

Infection is an uncommon complication of anterior cervical spine surgery. Most deep postoperative infections are thought to be related to occult esophageal perforation. Direct inoculation from the oropharynx has not been previously reported in the literature.

PURPOSE

The purpose of this study is to report a case of recurrent infection after anterior cervical decompression and fusion suspected to have resulted from direct communication between the oropharynx and deep neck space.

STUDY DESIGN

This study is a case report.

METHODS

This study included longitudinal clinical and radiological follow-up.

RESULTS

A 48-year-old woman who underwent anterior cervical corpectomy and fusion from C3 to C6 and posterior spinal fusion from C3 to C7 presented at 2 weeks and 5 months postoperatively with a deep neck space infection. She underwent surgical debridement each time. Workup of the second infection found a subtle cortical breach in the mandible at the site of prior invasive dental work.

CONCLUSIONS

This case describes the workup and management of a patient who presented with recurrent deep neck space infection following anterior cervical spine surgery. This is the first report of a postoperative infection related to direct communication between the oropharynx and deep neck space via a cortical breach of the mandible.

摘要

背景

感染是颈椎前路手术罕见的并发症。大多数术后深部感染被认为与隐匿性食管穿孔有关。文献中此前尚未报道过口咽直接接种导致感染的情况。

目的

本研究旨在报告一例颈椎前路减压融合术后反复感染的病例,怀疑是由于口咽与颈部深部间隙直接相通所致。

研究设计

本研究为病例报告。

方法

本研究包括纵向临床和影像学随访。

结果

一名48岁女性接受了C3至C6颈椎椎体次全切除融合术以及C3至C7后路脊柱融合术,术后2周和5个月出现颈部深部间隙感染。她每次均接受了手术清创。对第二次感染的检查发现,在先前进行侵入性牙科治疗的部位,下颌骨有细微的皮质破损。

结论

本病例描述了一名颈椎前路手术后出现反复颈部深部间隙感染患者的检查和治疗过程。这是首例因口咽通过下颌骨皮质破损与颈部深部间隙直接相通而导致术后感染的报告。

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