title: Cervical spondylodiscitis with epidural abscess after knife stab wounds to the neck: A case report.
abstract: BACKGROUND
  Cervical spondylodiscitis is usually caused by pyogenic infections, associated with retropharyngeal abscesses, or due to the swallowing of foreign bodies. No cases of cervical spondylodiscitis caused by a penetrating neck injury have been published in the literature. We describe a case of cervical spondylodiscitis after multiple knife stab wounds to the lateral soft tissue of the neck.
  
  
  METHODS
  Case report and review of the literature.
  
  
  RESULTS
  A 54-year-old patient was brought to our clinic with destructive spondylodiscitis C3/4 with paravertebral and epidural abscesses. He had been involved in a fight and had suffered multiple stab wounds to his neck with a knife 1 month prior. The initial CT scan had revealed one deeper wound canal behind the sternocleidomastoid muscle on the left side without any injury to the vessels. The wound was cleaned and an antibiotic therapy with cefuroxime was given for 1 week. After an uneventful and complete healing of the wound the patient developed severe neck pain. Inflammatory laboratory parameters were elevated, and a MRI of the neck revealed a distinct spondylodiscitis C3/4 with paravertebral and epidural abscess formations. Surgery was performed and included debridement, abscess drainage, decompression of the spinal canal, fusion of the C3/4 segment using an autologous iliac crest bone graft and a plate osteosynthesis. A course of calculated antibiotic therapy was administered for 8 weeks. Normal laboratory parameters and no radiological signs of an ongoing inflammatory process were observed during follow-up examinations. The C3/4 segment was consolidated.
  
  
  CONCLUSIONS
  Stab wound injuries to the neck not only bear the risk of injuries to the nerves, vessels and organs of the neck but also increase the risk of developing secondary spondylodiscitis. Specifically, cervical spondylodiscitis can result in distinct neurological symptoms, and surgical intervention should be performed in a timely manner.
authors.affiliation: Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany. Electronic address: anna.voelker@medizin.uni-leipzig.de.
authors.forename: Anna
authors.initials: A
authors.lastname: Voelker
authors.affiliation: Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany. Electronic address: nicolas.vonderhoeh@medizin.uni-leipzig.de.
authors.forename: Nicolas H
authors.initials: NH
authors.lastname: von der Hoeh
authors.affiliation: Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany. Electronic address: jens.gulow@medizin.uni-leipzig.de.
authors.forename: Jens
authors.initials: J
authors.lastname: Gulow
authors.affiliation: Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany. Electronic address: christoph-eckhard.heyde@medizin.uni-leipzig.de.
authors.forename: Christoph-Eckhard
authors.initials: CE
authors.lastname: Heyde
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D015299:Discitis / Q000175:diagnosis* / Q000188:drug therapy; D020802:Epidural Abscess / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D013166:Spondylitis / Q000175:diagnosis* / Q000188:drug therapy; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D016896:Treatment Outcome; D014951:Wounds, Stab / Q000150:complications* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Cervical epidural abscess; Cervical spondylodiscitis; Inflammation cervical spine; Stab wound to the neck