Esophageal Perforation Following Anterior Cervical Spine Surgery: Case Report and Review of the Literature

Abstract

Study Design:Multicenter retrospective case series and review of the literature.Objective:To determine the rate of esophageal perforations following anterior cervical spine surgery.Methods:As part of an AOSpine series on rare complications, a retrospective cohort study was conducted among 21 high-volume surgical centers to identify esophageal perforations following anterior cervical spine surgery. Staff at each center abstracted data from patients’ charts and created case report forms for each event identified. Case report forms were then sent to the AOSpine North America Clinical Research Network Methodological Core for data processing and analysis.Results:The records of 9591 patients who underwent anterior cervical spine surgery were reviewed. Two (0.02%) were found to have esophageal perforations following anterior cervical spine surgery. Both cases were detected and treated in the acute postoperative period. One patient was successfully treated with primary repair and debridement. One patient underwent multiple debridement attempts and expired.Conclusions:Esophageal perforation following anterior cervical spine surgery is a relatively rare occurrence. Prompt recognition and treatment of these injuries is critical to minimizing morbidity and mortality.

Covering of Plate after Anterior Cervical Fusion in Patients with Complete Spinal Cord Injury to Prevent Esophageal Injury: Technical Note

“…12 Halani et al performed a systematic review of patients who underwent anterior spinal surgery and sustained some form of esophageal perforation. 7 Although it seems that most cases of esophageal perforation are discovered perioperatively, during the acute or subacute postoperative period, 6 there are considerable reports of delayed presentations especially among quadriplegic patients. Newhouse et al surveyed 22 cases of esophageal perforation following anterior cervical spine surgery.…”

“…5 This frequency in other reports ranges from 0 to 1.62%. 1,6 This life-threatening injury could lead to dysphasia, osteomyelitis, mediastinitis, sepsis, and death. At the same time, it is difficult to diagnose because of only vague presentations.…”

Anterior Spinal Plates, Cervical

“…Permanent complications following ACDF are exceptionally rare, and many short-term complications can be avoided with sufficient evaluation and surgical technique (Quintana 2014). The rate of post-operative complications following anterior cervical fusion increases with the number of levels operated on (Quintana 2014;Nanda et al 2014;Bazaz et al 2002;Park and Jho 2012;Odate et al 2017;Zhong et al 2013;Gaudinez et al 2000;Hershman et al 2017). Complications include post-operative hematoma, transient dysphagia, recurrent laryngeal nerve (RLN) palsy, Horner's syndrome (characterized by anhidrosis, miosis, and ptosis ipsilateral to the lesion), esophageal perforation, wound infection, vascular injury, and cerebrospinal fluid (CSF) leak (Quintana 2014;Nanda et al 2014;Bazaz et al 2002;Park and Jho 2012;Odate et al 2017;Zhong et al 2013;Gaudinez et al 2000;Hershman et al 2017).…”

“…This requires immediate evacuation to prevent permanent sequelae). Other complications requiring surgical revision include CSF leak (0.2-1%) and esophageal perforation (0.25%) (Quintana 2014;Nanda et al 2014;Bazaz et al 2002;Park and Jho 2012;Odate et al 2017;Zhong et al 2013;Gaudinez et al 2000;Hershman et al 2017;Jung et al 2005).…”

Pharynxpenetration einer Schraube nach ventraler HWS-Spondylodese

“…In der Regel sind Komplikationen selten. Es werden Schluckbeschwerden in Form von Fremdkörpergefühl und Halsschmerzen sowie Dislokationen von Schrauben und Platten, Liquorleckage, wiederkehrende Kehlkopfverletzungen, pharyngoesophageale Verletzungen, prävertebrale Abszesse, Obstruktion der Atemwege, Mediastinitiden und Rupturen der A. carotis beschrieben [1][2][3][4].…”