Esophageal erosion 9 years after anterior cervical plate implantation

Lu, Daniel C.; Theodore, Pierre; Korn, W. Michael; Chou, Dean

doi:10.1016/j.surneu.2007.02.037

Cited by 42 publications

(31 citation statements)

References 17 publications

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“…The most frequent hardware complication is a broken or loosened screw or plate [8], which usually can be managed conservatively. However, erosion or migration of a loosened screw or plate into the lumen of the pharynx or esophagus has also been documented in the surgical literature as a much less common but more serious complication of this procedure [9][10][11][12][13][14][15][16][17]. The temporal relationship between implantation of an anterior cervical plate and erosion of the plate into the pharynx or esophagus is quite variable.…”

Section: Discussionmentioning

confidence: 99%

“…In other patients with this complication, however, surgery was required for repair of the perforation and removal of the cervical hardware [9,13,15]. The mechanism for erosion of an anterior cervical plate into the pharynx or esophagus is not well understood.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism for erosion of an anterior cervical plate into the pharynx or esophagus is not well understood. In some cases, the relatively sharp edge of a loosened screw or plate abutting the pharynx or esophagus could be responsible for erosion of this hardware into the lumen [9,17]. Contraction of the pharyngoesophageal junction during swallowing and additional posteriorly directed compression by the trachea could accentuate contact between the pharynx or esophagus and adjacent cervical hardware, even in the absence of loosening.…”

Section: Discussionmentioning

confidence: 99%

“…In one series, loosened or broken plates or screws were reported in 35% of patients who underwent this procedure [8]. Because of its location in the neck, the cervical plate or screws can also erode or migrate into the adjacent pharynx or esophagus, causing pharyngeal or esophageal perforation-a complication that has been well documented in the surgical literature [9][10][11][12][13][14][15][16][17]. To our knowledge, however, this complication has not been reported previously in the radiology literature.…”

mentioning

confidence: 88%

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Erosion of Anterior Cervical Plate into Pharynx with Pharyngotracheal Fistula

Kuo

Levine

2010

Dysphagia

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We report a 58-year-old woman who presented with dysphagia and recurrent episodes of coughing and choking during swallowing 10 years after anterior cervical discectomy and fusion with implantation of an anterior cervical plate. Barium esophagography revealed erosion of the cervical plate through the posterior wall of the pharyngoesophageal junction with an extraluminal collection that extended inferiorly as a track through the posterior wall of the trachea, producing a pharyngotracheal fistula. The pharyngeal perforation was repaired and the cervical hardware removed at surgery. This rare complication of anterior cervical discectomy and fusion should be recognized as a potentially serious but treatable long-term sequela of an anterior cervical plate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 88%

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Erosion of Anterior Cervical Plate into Pharynx with Pharyngotracheal Fistula

Kuo

Levine

2010

Dysphagia

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“…Just as the two delay cases caused by formation of pharyngoesophageal diverticulum were reviewed [12,13]. Lastly, the chronic intrinsic esophageal disease that had weakened the walls of the esophagus is mentioned in a case of 9-year delay esophageal perforation [14]. In this case, there were two potential factors contributing to pharyngoesophageal perforation.…”

Section: Etiologymentioning

confidence: 99%

Pharyngoesophageal perforation 3 years after anterior cervical spine surgery: a rare case report and literature review

Yin

Yang

Huang

et al. 2015

Eur Arch Otorhinolaryngol

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Pharyngoesophageal perforation after anterior cervical spine surgery is rare and the delayed cases were more rarely reported but potentially life-threatening. We report a case of pharyngoesophageal perforation 3 years after anterior cervical spine surgery. The patient presented with dysphagia, fever, left cervical mass and developing dyspnea 3 years after cervical spine surgery for trauma. After careful examinations, he underwent an emergency tracheostomy, neck exploration, hardware removal, abscess drainage and infected tissue debridement. 14 days after surgery, CT of the neck with oral contrast demonstrated no contrast extravasation from the esophagus. Upon review of literature, only 14 cases of pharyngoesophageal perforation more than 1 year after anterior cervical spine surgery were found. We discussed possible etiology, diagnosis and management and concluded that in cases of dysphagia, dyspnea, cervical pain, swelling and edema of the cervical area even long time after anterior cervical spine surgery, potential pharyngoesophageal damage should be considered.

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Repair of esophageal perforation due to anterior cervical spine instrumentation

et al. 2010

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The complication of esophageal perforation after anterior cervical spine fusion for cervical spine disease is rare but potentially fatal. We describe two cases of esophageal perforation found by esophagoscopic visualization. In one patient, primary closure could not be achieved, and a submental island flap was used to repair the defect. In the second patient, primary closure was achieved and a pectoralis major flap was interposed between the closure and the residual instrumentation. Postoperatively, both patients had no evidence of persistent perforation and had resolution of preoperative symptoms.

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Esophageal erosion 9 years after anterior cervical plate implantation

Cited by 42 publications

References 17 publications

Erosion of Anterior Cervical Plate into Pharynx with Pharyngotracheal Fistula

Erosion of Anterior Cervical Plate into Pharynx with Pharyngotracheal Fistula

Pharyngoesophageal perforation 3 years after anterior cervical spine surgery: a rare case report and literature review

Repair of esophageal perforation due to anterior cervical spine instrumentation

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