Life-threatening cervical spine collapse as a result of postradiation osteonecrosis-case report and review of the literature.
BACKGROUND
Mandibular osteoradionecrosis (ORN) is a well-known complication of head and neck radiotherapy; however, ORN of the cervical spine is rarely reported.


METHODS
Herein, we present a patient with a history of tonsillar carcinoma treated with chemoradiation who developed acute, severe progressive neck pain due to cervical spine collapse as a result of ORN. We also discuss diagnosis and treatment of cervical ORN based on a review of the literature.


RESULTS
The patient was successfully treated with antibiotics and surgical debridement and fixation.


CONCLUSIONS
Delayed diagnosis of cervical ORN can result in marked disability and pain due to spinal cord compression, as well as serious deformity and instability requiring surgical intervention, and even death. It is important for otolaryngologists who treat head and neck malignancies to be aware of this potential complication so that patients may be diagnosed as early as possible and treated with conservative measures.
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Valerie A
VA
Smith
Eric J
EJ
Lentsch
D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000150:complications* / Q000000981:diagnostic imaging; D011879:Radiotherapy Dosage; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D000077195:Squamous Cell Carcinoma of Head and Neck; D014057:Tomography, X-Ray Computed; D014067:Tonsillar Neoplasms / Q000628:therapy*