87-Year-Old Woman With Painful Swallowing

Khoo, Shiao-Yen; Deimel, George W.; Park, John G.

doi:10.4065/mcp.2010.0352

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…Persistent leukocytosis is particularly common with esophageal perforation, and clinical concern is warranted in the case of fevers and leukocytosis unresponsive to broad-spectrum antibiotics. 14 Further diagnostic support may be provided by an elevated C-reactive protein, which would be expected to routinely normalize in approximately 6 days after surgery. 15 Clinical suspicion of a cervical spinal infection in a stable patient should be followed by an immediate magnetic resonance imaging of the spine to confirm abscess.…”

Section: Discussionmentioning

confidence: 99%

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Anterior Cervical Infection: Presentation and Incidence of an Uncommon Postoperative Complication

Ghobrial

Sasso

Tannoury

et al. 2017

Global Spine Journal

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Study Design:Retrospective multi-institutional case series.Objective:The anterior cervical discectomy and fusion (ACDF) affords the surgeon the flexibility to treat a variety of cervical pathologies, with the majority being for degenerative and traumatic indications. Limited data in the literature describe the presentation and true incidence of postoperative surgical site infections.Methods:A retrospective multicenter case series study was conducted involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network, selected for their excellence in spine care and clinical research infrastructure and experience. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, inclusive, were reviewed to identify the occurrence of 21 predefined treatment complications. Patients who underwent an ACDF were identified in the database and reviewed for the occurrence of postoperative anterior cervical infections.Results:A total of 8887 patients were identified from a retrospective database analysis of 21 centers providing data for postoperative anterior cervical infections (17/21, 81% response rate). A total of 6 postoperative infections after ACDF were identified for a mean rate of 0.07% (range 0% to 0.39%). The mean age of patients identified was 57.5 (SD = 11.6, 66.7% female). The mean body mass index was 22.02. Of the total infections, half were smokers (n = 3). Two patients presented with myelopathy, and 3 patients presented with radiculopathic-type complaints. The mean length of stay was 4.7 days. All patients were treated aggressively with surgery for management of this complication, with improvement in all patients. There were no mortalities.Conclusion:The incidence of postoperative infection in ACDF is exceedingly low. The management has historically been urgent irrigation and debridement of the surgical site. However, due to the rarity of this occurrence, guidance for management is limited to retrospective series.

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Section: Discussionmentioning

confidence: 99%

“…Prior study has shown that leukocytosis is invariably persistent in the postoperative setting with esophageal perforation. 14 Moreover, in the case of a suspected esophageal perforation on clinical or direct fiber-optic evaluation, barium esophagogram has been shown to be an effective test for the diagnosis of esophageal leak. 24 …”

Section: Discussionmentioning

confidence: 99%

Anterior Cervical Infection: Presentation and Incidence of an Uncommon Postoperative Complication

Ghobrial

Sasso

Tannoury

et al. 2017

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…It is iatrogenic in at least 70% of cases, implicating surgical instruments [24]. It may show early or late symptomatology, with cervical or retrosternal pain, hematemesis, odynophagia or dysphagia [25][26][27]. There are subacute forms secondary to deep retropharyngeal abscess.…”

Section: Particular Case Of Early Pharyngoesophageal or Pharyngeal Pementioning

confidence: 99%

Anterior cervical spine surgical site infection and pharyngoesophageal perforation. Ten-year incidence in 1475 patients

Gamain

Coulomb

Houzir³

et al. 2019

Orthopaedics & Traumatology: Surgery & Research

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Background: Surgical site infection is reputed to be infrequent in anterior cervical spine surgery. Data on pathophysiological mechanism and risk factors are sparse. The relationship between local site infection and pharyngoesophageal perforation is unclear. The present study aimed: (1) to estimate the incidence of surgical site infection in anterior cervical spine surgery, (2) estimate the incidence of associated pharyngoesophageal perforation, and (3) suggest a decision-tree for early management of this twofold issue. Hypothesis: Although with very low incidence, anterior cervical spine surgical site infection and pharyn-goesophageal perforation are frequently associated. Material and methods: A 2-center retrospective study included all anterior cervical spine surgeries between January 1, 2007 and December 31, 2016. Data were provided by the two medical information departments. Patients undergoing anterior revision surgery on the cervical spine were included. Files were analyzed to determine whether the revision surgery was secondary to surgical site infection. Results: In total, 1475 patients with anterior cervical spine surgery were identified: 1180 in center A (80%) and 295 in center B (20%). The rate of revision surgery for surgical site infection was 0.34% (5/1475). There were 3 cases of pharyngoesophageal perforation (0.2%). Discussion: The incidence of revision surgery for anterior cervical spine surgical site infection was comparable to rates in the international literature (0.07-1.6%). An association between surgical site infection and pharyngoesophageal perforation was frequent, but not statistically significant. This complication is extremely serious, requiring urgent multidisciplinary management.

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Infections du site opératoire et plaies oeso-pharyngées après chirurgie antérieure du rachis cervical. Incidence à propos de 1475 patients opérés sur 10 ans

Gamain

Coulomb

Houzir³

et al. 2019

Revue de Chirurgie Orthopédique et Traumatologique

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87-Year-Old Woman With Painful Swallowing

Cited by 3 publications

References 14 publications

Anterior Cervical Infection: Presentation and Incidence of an Uncommon Postoperative Complication

Anterior Cervical Infection: Presentation and Incidence of an Uncommon Postoperative Complication

Anterior cervical spine surgical site infection and pharyngoesophageal perforation. Ten-year incidence in 1475 patients

Infections du site opératoire et plaies oeso-pharyngées après chirurgie antérieure du rachis cervical. Incidence à propos de 1475 patients opérés sur 10 ans

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