case_images: PMC10896660_01
case_images: Preoperative radiological images.. Sagittal whole-spine T2-weighted magnetic resonance images showing a retropharyngeal abscess (white arrow) and epidural abscess (white arrowheads). Hyperintensity of C5 and C6 vertebral bodies suggest pyogenic spondylitis. Fluid collection in the intervertebral spaces of C5/6, Th12/L1, L3/4, L4/5, and L5/S1 appear to be spondylodiscitis (A: cervicothoracic regions, B: thoracic regions, C: thoracic-lumbar-sacral regions).
case_images: cureus-0016-00000053070-i01.jpg
case_images: PMC10896660_01_cureus-0016-00000053070-i01.jpg
case_images: FIG1
case_images: Cervical spondylosis and adult spinal deformity were also identified (Figure 1).
case_images: Radiographic images after the first operation.. Anterior cervical discectomy and fusion of C4/5 and C5/6 and posterior cervical fixation from C2 to C7. The bone graft at C5/6 extruded anteriorly, however, postoperative dysphagia did not occur (A: lateral projection; B: anterior-posterior projection).
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case_images: PMC10896660_01_cureus-0016-00000053070-i02.jpg
case_images: FIG2
case_images: Abscess at the intervertebral level of C5/6 was simultaneously drained, the infectious intervertebral discs were debrided, and an autologous iliac bone graft was placed in the intervertebral spaces of C4/5 and C5/6 (Figure 2).
case_images: Magnetic resonance images after circumferential cervical fixation.. Cervical epidural abscesses, pyogenic spondylitis, and spondylodiscitis resolved after cervical fixation surgery. The persistent epidural abscess at the lower thoracic and lumbosacral levels is identified (white arrowheads). Hyperintensity in the vertebral bodies of Th12 and L1 signifies de novo pyogenic spondylitis due to spread of infection (white arrows)(A: cervicothoracic regions; B: thoracic regions; C: thoracic-lumbar-sacral regions).
case_images: cureus-0016-00000053070-i03.jpg
case_images: PMC10896660_01_cureus-0016-00000053070-i03.jpg
case_images: FIG3
case_images: Another follow-up whole-spine MRI examination showed resolution of the cervical pyogenic spondylitis and epidural abscess; however, persistent epidural abscess and pyogenic spondylitis were suspected below the Th12 level (Figure 3).
case_images: Radiographic images after the second operation. Oblique and posterior lumbar intervertebral fixations concurrently performed with posterior long fusion from Th10 to the ilium. The Cobb angle and sagittal vertical axis were 15.9  and 50.5mm, respectively (A: lateral projection; B: anteroposterior projection). Sagittal spinal magnetic resonance imaging five months after the second surgery reveals resolution of the retropharyngeal abscess, epidural abscess, spondylodiscitis, and pyogenic spondylitis (C). Achievement of bone fusion is identified on computed tomography images six months after the second surgery (D-F)
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case_images: PMC10896660_01_cureus-0016-00000053070-i04.jpg
case_images: FIG4
case_images: OLIF at Th12/L1, L3/4, and L4/5, PLIF at L5/S1, and posterior fixation from Th10 to the ilium via PPSs (Figures 4A, 4B). OLIF and PLIF were performed to debride the infectious intervertebral discs, drainage abscess, and acquire stabilization. Association cervical myelopathy evaluation questionnaire score was 13/17. At the time of this report, no apparent recurrence of the epidural abscess or pyogenic spondylitis was observed (Figure 4C). Bone fusion following fixation surgery was observed on follow-up images six months after the second surgery (Figures 4D-4F).