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Life‐threatening cervical spine collapse as a result of postradiation osteonecrosis—case report and review of the literature
Author(s) -
Smith Valerie A.,
Lentsch Eric J.
Publication year - 2013
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.22001
Subject(s) - medicine , osteoradionecrosis , surgery , complication , radiation therapy , neck pain , deformity , spinal cord compression , spinal cord , alternative medicine , pathology , psychiatry
Abstract 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. Conclusion 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. © 2012 Wiley Periodicals, Inc. Head Neck, 2013