Prevertebral Space

spatium praevertebrale

The prevertebral space lies posterior to the prevertebral fascia (anterior to the vertebral bodies and prevertebral muscles — longus colli and capitis), extending from the skull base to the coccyx. It contains the vertebral column, the prevertebral muscles, the sympathetic chain, and the vertebral arteries. It is distinct from the danger space (between the alar and prevertebral fascia) which provides a direct path to the posterior mediastinum.

Region: Neck

Clinical Relevance

Clinical Notes

Prevertebral space infection from vertebral osteomyelitis (most commonly Staphylococcus aureus or TB) presents as a retropharyngeal bulge on lateral neck radiograph and CT. The prevertebral space infection can spread inferiorly into the posterior mediastinum through the danger space. Anterior approach to the cervical spine (ACDF) passes through the prevertebral fascia to expose the longus colli and anterior vertebral bodies. The sympathetic chain runs lateral to the prevertebral space and its disruption in anterior cervical approaches causes Horner syndrome.

Pathology

Common Injuries & Conditions

Prevertebral Space Abscess from Vertebral Osteomyelitis

Haematogenous vertebral osteomyelitis erodes the anterior vertebral cortex into the prevertebral space, producing an anterior retropharyngeal collection visible as a midline soft tissue bulge on lateral neck CXR and CT; drainage through the anterior neck or transoral approach decompresses the collection and vertebral stabilisation addresses the underlying osteomyelitis.