Esophageal Perforations After Anterior Cervical Surgery

Gaudinez, Ricardo; English, Gerald M.; Gebhard, James S.; Brugman, John L.; Donaldson, David H.; Brown, Courtney W.

doi:10.1097/00002517-200002000-00015

Cited by 190 publications

(159 citation statements)

References 39 publications

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“…Plating has been reported to achieve a fusion rate up to 98%, resulting in early mobilization and reduced graft-related complications, especially in a multilevel fusion [2][3][4][5][6][7][8][9][10][11][12]. The overall complication rate is generally low, although the incidence is probably underestimated (range 5-20%).…”

Section: Discussionmentioning

confidence: 99%

“…Among them pharyngo-esophageal perforation is uncommon, but of utmost importance for the possibility of graft infection leading to osteomyelitis, medistinitis, sepsis and death. Its incidence is low and estimated between 0.02 and 1.49%, but its mortality is high ranging between 12 and 20% [3,4,7,[9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

“…Non-penetrating trauma leads to pharyngeal or esophageal perforation with two mechanisms: hyperextension and laceration by anterior cervical osteophytes or entrapment of esophageal wall between vertebral bodies at the time of fracture reduction. The clinical presentation is usually acute and the most vulnerable site is at the level of the crico-pharyngeus muscle or the pyriform sinus [3,4,[6][7][8]. Surgical causes may be further subdivided into acute or delayed.…”

Section: Discussionmentioning

confidence: 99%

“…This has resulted in an early spine stability, early patient mobilization, improved union rate and reduced hospital stay. Further, the technique has decreased the need for rigid external immobilization and reduced the indication for posterior procedures [2,4,5,9].…”

Section: Introductionmentioning

confidence: 99%

“…Various etiologies have been identified: penetrating and non-penetrating trauma, iatrogenic surgical lesions and chronic erosion from synthesis devices, usually following migration [4,7,[9][10][11]. Occasional reports of esophageal perforation without plate displacement have been described and controversy exists about optimal management [6][7][8]11].…”

Section: Introductionmentioning

confidence: 99%

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Successful surgical management of a delayed pharyngo-esophageal perforation after anterior cervical spine plating

et al. 2008

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A case report of a 41-year-old man who had a delayed pharyngo-esophageal perforation without instrumentation failure 7 years after anterior cervical spine plating is presented and the literature on this issue is reviewed. This injury resulted from repetitive friction/ traction between the retropharyngo-esophageal wall and the cervical plate construct leading to a pseudodiverticulum and perforation. Successful treatment of the perforation was obtained after surgical repair using a sternocleidomastoid muscle flap. This case stresses the necessity of careful long-term follow-up in patients with anterior cervical spine plating for early detection of possible perforation and the use of muscle flap as the treatment of choice during surgical repair.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Successful surgical management of a delayed pharyngo-esophageal perforation after anterior cervical spine plating

et al. 2008

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Progressive Dysphagia in a Patient With a History of Cervical Spine Fusion

Azadarmaki

Soliman

2014

JAMA Otolaryngol Head Neck Surg

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Management of Iatrogenic Cervical Esophageal Perforations

Chen

Shapira‐Galitz

Garber

et al. 2020

JAMA Otolaryngol Head Neck Surg

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sophageal perforation is a rare but life-threatening condition that is difficult to diagnose and treat, with an incidence of 3.1 cases per 1 000 000 per year. 1 It has an overall mortality rate of 13.3%, but this percentage varies from 4% to 80% depending on the type of perforation and the time to diagnosis. 2 Discrepancies in the diagnosis and management of esophageal perforations also contribute to the wide range of mortality rates. The most common causes of esophageal perforation are iatrogenic (46.5%), spontaneous (37.8%), foreign body (6.3%), corrosive (1.8%), and traumatic (<1%). 2,3 Overall, 72.6% of esophageal perforations are thoracic, 15.2% are cervical, and 12.5% are abdominal. 2 Cervical esophageal perforations (CEPs) have a mortality rate of 6% to 8%, [4][5][6][7] which is the lowest mortality rate for esophageal perforations. However, there is little existing literature that focuses specifically on cervical perforations. A 10-year cross-sectional study 4 of CEPs found them to be due to iatrogenic injury (58%), foreign body ingestion (27%), and penetrating injury (15%). Iatrogenic CEPs (iCEPs) are unique among CEPs for various reasons. The increased frequency of endoscopy for diagnosis and treatment has led to a rising number of iatrogenic esophageal injuries. 8 In addition, the management of iCEPs is controversial and lacking in evidence. Conservative management includes antibiotics and feeding tube placement, but cervical drainage is also frequently added to this treatment regimen. More aggressive surgical approaches to treatment, such as pri-

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Esophageal Perforations After Anterior Cervical Surgery

Cited by 190 publications

References 39 publications

Successful surgical management of a delayed pharyngo-esophageal perforation after anterior cervical spine plating

Successful surgical management of a delayed pharyngo-esophageal perforation after anterior cervical spine plating

Progressive Dysphagia in a Patient With a History of Cervical Spine Fusion

Management of Iatrogenic Cervical Esophageal Perforations

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