New concepts in the diagnosis and treatment of infections of the cervical spine.

Of the three major areas of the spinal column, the cervical spine is least commonly infected; approximately 3 to 5 per cent of all spinal infections involve the cervical spine. Tuberculous, pyogenic, fungal, and parasitic infections may involve the cervical spine and occur in this order of decreasing frequency. Difficulty in differential diagnosis most commonly involves tumor. Fungal and parasitic infections of the cervical spine are extremely rare, but fungal infections have been increasing over the past three decades. Clinical suspicion, radiologic examination, and definitive diagnosis via tissue biopsy are necessary so that definitive procedures can be instituted. Specific antibiotic coverage, surgery to facilitate the body's defenses and antibiotic penetration, and stabilization of the spine are the most important therapeutic measures to be instituted.