Life-threatening cervical spine collapse as a result of postradiation osteonecrosis-case report and review of the literature.

Abstract

Mandibular osteoradionecrosis (ORN) is a well-known complication of head and neck radiotherapy; however, ORN of the cervical spine is rarely reported. 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. The patient was successfully treated with antibiotics and surgical debridement and fixation. 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.