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

Abstract

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.

Esophageal perforation after anterior cervical spine surgery: a systematic review of the literature

“…All duplicate articles, abstracts, review articles, and letters to the editor were excluded. [1][2][3][4][5]8,10,[13][14][15][16][17][18][20][21][22][23][60][61][62]64,65,[67][68][69][70][71][72][73][74][75] Title and abstract review was performed once the initial list of studies was generated (Fig. 1).…”

Delayed esophageal perforation 17 years after anterior cervical fusion surgery with plating

“…Regarding the etiology of esophageal perforations due to the surgical causes, they can be roughly divided into two types caused by intra-operative and postoperative injuries. Most esophageal perforations could occur during the surgery of anterior cervical spine, including cervical dissection, excessive or prolonged retraction of pharyngeal and esophageal structure or the use of sharp instruments and drills [11]. Delayed injuries are the result of erosion of the posterior wall of the esophagus by the graft or the trouble between the posterior esophageal wall and the anterior cervical implant [12,13].…”

Осложнения Вентральной Межтеловой Фиксации Шейных Позвонков Динамическими Пластинами

“…При изучении литературы обраща-ют на себя внимание случаи перфо-рации пищевода после выполнения переднего межтелового спондилодеза с использованием ротационных дина-мических пластин и костных корти-кально-губчатых аутотрансплантатов [22,28,35,39]. Они были обусловле-ны как поломкой и миграцией винтов [28], так и миграцией динамических пластин и винтов (рис.…”

“…Они были обусловле-ны как поломкой и миграцией винтов [28], так и миграцией динамических пластин и винтов (рис. 3а) [22,35,39].…”