Lateral cervical spine film shows widening of the prevertebral
space and destruction of C5 and C6 vertebrae.
Middle aged woman with a history of intravenous drug use, presented with progressive, excruciating neck pain radiating to the shoulders.
Examination of the neck did not reveal any external abnormalities. The posterior pharyngeal wall looked normal. A lateral cervical spine x-ray showed widening of the prevertebral / retropharyngeal space, with destruction of the 5th and 6th cervical vertebral bodies.
MRI scan showed a prevertebral abscess with extension into the spinal canal and compression of the cord.
The abscess was drained through a left neck incision. Cultures grew Methicillin-resistant Staphylococcus aureus (MRSA) and the patient was given intravenous antibiotics for several weeks. A titanium halo was placed by the neurosurgeon to stabilize the cervical spine, pending cervical spine fusion at a later date.
Axial MRI scan showing the extension of the prevertebral abscess into the spinal canal.
Sagittal MRI scan clearly showing the abscess cavity opposite C4-C5. Note the destruction of C5 and C6, collapse of the intervertebral space and posterior extension of the abscess into the spinal canal.
Bechara Y. Ghorayeb, MD. 1140 Business Center Drive, Suite 560. Houston, TX 77043.