• Masaki Fujioka, Kiyoshi Oka, Riko Kitamura, and Aya Yakabe.
• Department of Plastic and Reconstructive Surgery, National Hospital organization Nagasaki Medical Center, Nagasaki, Japan. mfujioka@nmc.hosp.go.jp
• Surg Neurol. 2009 Dec 1;72(6):761-4; discussion 764.

BackgroundSpinal osteomyelitis and epidural abscess are uncommon but have a potentially disastrous outcome, although the surgical techniques and antimicrobial therapy have advanced.Case DescriptionWe present a case of cervical osteomyelitis and epidural abscess resulting from pharyngeal squamous cell carcinoma ablation, which were treated with a pectoralis major muscle flap successfully.ConclusionMuscle flap insertion to the cervical contaminated wound enables radical removal of the contaminated tissue, and the muscle flaps for dead-space obliteration and neovasculation were obligatory for successful management of the infected complex wound. Furthermore, the inserted pectoralis major muscle flap can divide vertebrae and epidural canal from these origins of infection. We believe that this technique is simple, can be performed in a one-stage management, has minimal associated morbidity, and thus, is advocated as a desirable treatment option in the treatment of cervical osteomyelitis and epidural abscess.Copyright 2009 Elsevier Inc. All rights reserved.

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