Cervical osteomyelitis and epidural abscess treated with a pectoralis major muscle flap.
BACKGROUND
Spinal osteomyelitis and epidural abscess are uncommon but have a potentially disastrous outcome, although the surgical techniques and antimicrobial therapy have advanced.


METHODS
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.


CONCLUSIONS
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.
Fujioka
Masaki
M
Department of Plastic and Reconstructive Surgery, National Hospital organization Nagasaki Medical Center, Nagasaki, Japan. mfujioka@nmc.hosp.go.jp
Oka
Kiyoshi
K
Kitamura
Riko
R
Yakabe
Aya
A
D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002574:Cervical Vertebrae / Q000601:surgery*; D003646:Debridement / Q000379:methods; D020802:Epidural Abscess / Q000175:diagnosis / Q000601:surgery*; D005402:Fistula / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010019:Osteomyelitis / Q000175:diagnosis / Q000601:surgery*; D010608:Pharyngeal Diseases / Q000175:diagnosis / Q000601:surgery*; D010610:Pharyngeal Neoplasms / Q000601:surgery; D012086:Reoperation; D013122:Spinal Diseases / Q000175:diagnosis / Q000601:surgery*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed