title: A Lethal Sequelae of Spinal Infection Complicating Surgery and Radiotherapy for Head and Neck Cancer.
abstract: Patients who have undergone neck dissection and radiotherapy are at risk of cervical spine infections. Furthermore, previous radiotherapy and cervical spine infections can lead to fistula formation to the subarachnoid space and intracranial infection. This report discusses the serious consequences of a missed cervical spine infection including cerebrospinal fluid fistula formation and persistent central nervous system infection, and serves as a reminder to clinicians of the possible association between cervical spine infections and prior head and neck surgery and radiotherapy. In all such cases, the posterior pharyngeal wall should be inspected during follow-up. Despite the appearance of an intracranial infection, the cervical spine should be investigated, especially if the response to appropriate antibiotics is suboptimal.
authors.affiliation: Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
authors.forename: Jason Pui Yin
authors.initials: JP
authors.lastname: Cheung
authors.affiliation: Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
authors.forename: Kin Cheung
authors.initials: KC
authors.lastname: Mak
authors.affiliation: Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
authors.forename: Helen Hoi Lun
authors.initials: HH
authors.lastname: Tsang
authors.affiliation: Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
authors.forename: Keith Dip Kei
authors.initials: KD
authors.lastname: Luk
keywords: Cerebrospinal fluid fistula; Cervical spine; Radiotherapy; Spondylodiscitis