Spontaneous healing of a shredded esophagus after ACDF without direct repair

Abstract

Esophageal perforation is a catastrophic complication of anterior cervical discectomy and fusion (ACDF). While direct surgical repair has been reported as optimal for restoration of upper gut function, we present the case of a 58-year-old woman who achieved complete resolution when treated only with debridement and drainage. We find that a supportive approach, surgical management without direct repair, may play a vital role in select patient populations in order to avoid potentially long-term consequences or radical treatments, like esophageal diversion. Decisions regarding direct repair versus debridement and inspection only should be made on a case-by-case basis through a multidisciplinary approach.

Pharyngo-Esophageal Perforation Following Anterior Cervical Spine Surgery: A Single Center Experience and a Systematic Review of the Literature

“…After eligibility assessment a total of 68 studies were included (Figure 3). 5,8-74 There were 62 case reports and case series (≤5 patients) 5,7…”

“…After eligibility assessment a total of 68 studies were included (Figure 3). 5, There were 62 case reports and case series (�5 patients) 5,33,34,59,[61][62][63][64][65][66][67][68]72,73 and 6 retrospective studies (>5 patients). 39,42,63,65,73,74 All included studies were level 4 evidence.…”

Six-year follow-up of a survivor of cervical spine fracture and dislocation with oesophageal perforation following long scarf syndrome - a case report and literature review

“…Firstly, the neurological level of the cervical spinal cord injury was at C5, which might partially lower the compromise of the respiratory and cardiovascular function after spinal cord injury. Secondly, the infection of the paravertebral space was fortunately localized to the neck without extension to mediastinum, which lowered the risk of severe sepsis and made repeated local care possible to control the infection [11,12]. Thirdly, though a halo-vest may restrict respiratory movement, it however provided solid immobilization of the cervical spine and made the position changing more easily.…”