Osteoradionecrosis of the cervical spine: an analysis of the literature

Victoria A. Mañón, Jonathan Shum

Research output: Contribution to journalReview articlepeer-review


Objectives: The purpose of this manuscript is to review the current literature on osteoradionecrosis of the cervical spine (C-ORN) and to summarize the risk factors, presenting symptoms and management strategies of this rare condition. Study Design: A systematic review of the literature on C-ORN was completed using PubMed. Nineteen articles met criteria; 97 patient cases were identified. Statistical analysis was completed from the patient cases. Results: Of the analyzed patients, 72% are male and 28% are female with an average age of 57.7 years. Nasopharyngeal carcinoma was the most common initial diagnosis (72%). Thyroid and other lower neck cancers were associated with a later onset of C-ORN compared with other cancers. C-ORN more commonly occurred in the clivus to C2 (55.3%, P = .004). Onset of C-ORN significantly differed for men (n = 6.99 years) and women (n = 17.5 years) (P = .022). Conclusion: C-ORN can be a devastating complication of head and neck radiation therapy. C-ORN is associated with nasopharyngeal carcinoma, and most commonly affects the area of the clivus to cervical vertebrae C2. Cancers of the lower neck and female sex are associated with later onset. Initial presentation ranges from asymptomatic to severe neurologic deficits; the degree of intervention should be congruent with the severity of presenting symptoms. As long-term survival of patients with head and neck cancer increase, this complication may become more prevalent.

Original languageEnglish (US)
Pages (from-to)591-595
Number of pages5
JournalOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Issue number5
StatePublished - May 2023


  • Female
  • Humans
  • Male
  • Middle Aged
  • Cervical Vertebrae/pathology
  • Head and Neck Neoplasms/pathology
  • Nasopharyngeal Carcinoma/complications
  • Nasopharyngeal Neoplasms/radiotherapy
  • Osteoradionecrosis/etiology
  • Retrospective Studies

ASJC Scopus subject areas

  • Oral Surgery
  • Radiology Nuclear Medicine and imaging
  • Dentistry (miscellaneous)
  • Surgery
  • Pathology and Forensic Medicine


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