Presentation
A 42-year-old man with a recently gangrenous great toe and diabetes presented to the emergency department with neck pain and progressive quadriparesis. His condition deteriorated rapidly.
Radiologic Findings
Gadolinium-enhanced axial and sagittal magnetic resonance imaging (MRI) of the cervical spine revealed C6 and C7 osteomyelitis with discitis, dural enhancement, and an epidural phlegmon (Figs. 70-1 and 70-2).
FIGURE 70-1 Gadolinium-enhanced axial MRI of the cervical spine demonstrates infection in the vertebral body and disc space with an epidural phlegmon.
Diagnosis
Cervical epidural abscess
Treatment
The patient was emergently taken to the operating room. A fiberoptic intubation was done and he had a two-level cervical corpectomy and fusion.
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