• Jinwei Ying, Shishen Pei, Linghao Su, Tianyong Wen, You Lv, and Dike Ruan.
• Department of Orthopedic Surgery, Navy General Hospital, Beijing, China; Southern Medical University, Guangzhou, China; Department of Orthopedic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
• World Neurosurg. 2018 Oct 1; 118: 250-260.

BackgroundCervical spondylodiscitis with spinal epidural abscess (SEA) is not a rare medical condition and usually requires urgent decompression of neural structures and stabilization of the spine followed by antibiotic therapy for the prevention of severe neurologic deficits.Case DescriptionIn this report, we present a 43-year-old male patient with the chief complaint of neck pain and intermittent fever accompanying by slight dysphagia. After 2 weeks, he felt mild and transient numbness on the left upper limb. He had a history of esophageal intervention under endoscopy. Magnetic resonance imaging disclosed diffuse hyperintensity in the left paraesophageal and prevertebral tissues and a space-occupying lesion within the spinal canal. The esophagography revealed a saclike barium collection parallel to the upper esophagus herniating out from the posterior wall without evident leakage. Neither surgical decompression nor drainage was chosen by this patient; conservative treatment with antibiotic administration was managed to achieve a good neurologic recovery and remarkable resolution of the epidural abscess. During antibiotic therapy and dietary restriction, the symptoms of diverticulitis was also managed expectantly.ConclusionsPhysicians need to be aware of this rare case of SEA secondary to esophageal diverticulitis. An early diagnosis and prompt administration of antibiotics is a key factor to avoid neurologic deterioration for the treatment of SEA caused by diverticulitis. Endoscopic or surgical repair of diverticulum may be warranted to avoid the recurrence of such infection.Copyright © 2018 Elsevier Inc. All rights reserved.

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