METHODS: Here, we report a case of 59-year-old male patient who developed deep cervical abscess 30 days after anterior cervical discectomy and titanium cage bone graft fusion (autologous bone) at C3/4 and C4/5. The patient did not have esophageal perforation. The abscess was managed through radical neck dissection approach with repated washing and removal of the titanium implant. Staphylococcus aureus was positively cultured from the abscess drainage, for which appropriate antibiotics including cefoxitin, vancomycin, levofloxacin, and cefoperazone were administered postoperatively. In addition, an external Hallo frame was used to support unstable cervical spine. The patient\'s deep cervical infection was healed 3 months after debridement and antibiotic administration. His cervial spine was stablized 11 months after the surgery with support of external Hallo Frame.
CONCLUSIONS: This case suggested that deep cervical infection should be considered if a patient had history of ACDF even in the absence of esophageal perforation.
方法:这里,我们报道了一例59岁的男性患者,他在颈前路椎间盘切除术和C3/4和C4/5钛笼植骨融合(自体骨)后30天出现了颈深脓肿.患者没有食管穿孔。脓肿通过根治性颈淋巴结清扫方法进行处理,并重新冲洗和去除钛植入物。脓肿引流处金黄色葡萄球菌阳性培养,包括头孢西丁在内的适当抗生素,万古霉素,左氧氟沙星,术后给予头孢哌酮。此外,使用外部Hallo框架支撑不稳定的颈椎。患者的宫颈深部感染在清创和抗生素使用后3个月愈合。手术后11个月,他的颈椎在外部Hallo框架的支持下稳定下来。
结论:该病例提示,即使没有食管穿孔,如果患者有ACDF病史,也应考虑宫颈深部感染。