Recurrent anterior cervical wound abscesses following cervical corpectomy and fusion surgery from an odontogenic source mimicking an esophageal perforation: a case report

BackgroundContext: Infection is an uncommon complication of anterior cervical spine surgery. Most deep postoperative infections are thought to be related to occult esophageal perforation. Direct inoculation from the oropharynx has not been previously reported in the literature.PurposeThe purpose of this study is to report a case of recurrent infection after anterior cervical decompression and fusion suspected to have resulted from direct communication between the oropharynx and deep neck space.Study DesignThis study is a case report.MethodsThis study included longitudinal clinical and radiological follow-up.ResultsA 48-year-old woman who underwent anterior cervical corpectomy and fusion from C3 to C6 and posterior spinal fusion from C3 to C7 presented at 2 weeks and 5 months postoperatively with a deep neck space infection. She underwent surgical debridement each time. Workup of the second infection found a subtle cortical breach in the mandible at the site of prior invasive dental work.ConclusionsThis case describes the workup and management of a patient who presented with recurrent deep neck space infection following anterior cervical spine surgery. This is the first report of a postoperative infection related to direct communication between the oropharynx and deep neck space via a cortical breach of the mandible.