Vertebral osteomyelitis with chronic cervical extradural abscess in a heroin addict

Chronic extradural abscess at C5-C6 level due to vertebral osteomyelitis is reported. The patient, a 26-year-old woman who had taken heroin intravenously for four years, developed progressive tetraparesis. Blood cultures and, at operation, the culture of the abscess drainage, grew Staphylococcus aureus. High resolution CT scan allowed for prompt diagnosis. Decompressive laminectomy and complete removal of the extradural mass were performed immediately, followed by multiple subtotal somatectomy (MSS) in order to obtain anterior decompression and mechanical reconstruction of the cervical column. The pathogenetic, diagnostic and surgical problems of spinal extradural abscess are discussed. Multiple subtotal somatectomy and its indication are described.