Head and Neck Imaging

Prevertebral space, cervical

anterior portion of the perivertebral space cervical, defined by the anterior part of the cervical spine and the deep layer of the deep cervical fascia running between the transverse processes of the spine. The prevertebral space extends from the skull base into the mediastinum; according to some authors it ends at the level of the fourth thoracic vertebra, other authors describe it as reaching the coccygeal level. The prevertebral space contains the prevertebral muscles (longus colli and longus capitis muscles), vertebral vessels, scalene muscles, phrenic nerve and proximal part of the brachial plexus.

Prevertebral space pathology for the most part originates from the cervical spine. The most common lesions include vertebral osteomyelitis and spondylodiscitis (Fig.1), and vertebral metastasis. Other lesions may be seen, such as non Hodgkin lymphoma head and neck manifestation (Fig.2), direct invasion by posterior spread of squamous cell carcinoma head and neck (Fig.3), inferior extension of a chordoma, and a variety of primary tumours arising from tissues belonging to this space.

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Fig.1

Axial CT images in an elderly patient with neck pain and odynophagia. a. Soft tissue window. Abscess formation in the epidural space, right neuroforamen and prevertebral space (arrows); the abscess extends into the retropharyngeal space (asterisk) through a hole in the deep layer of the deep cervical fascia. Enlarged pyramidal lobe of thyroid gland (arrowhead), presumably due to nodular hyperplasia (coincident finding). b. Bone window. Erosive changes are seen in midcervical vertebral end plates. Staphylococcal spondylodiscitis.
Prevertebral space, cervical, Fig.1 (a)
Prevertebral space, cervical, Fig.1 (b)
Prevertebral space, cervical, Fig.2
Prevertebral space, cervical, Fig.3