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Late Retropharyngeal and Parapharyngeal Abscess in Patients with a History of Anterior Cervical Discectomy and Fusion
Objective: Anterior cervical discectomy and fusion is a common procedure performed by spine surgeons with rare complications and high treatment success. Late presentation of retropharyngeal abscess in patients with a history of anterior cervical discectomy and fusion is rare but can have devastating...
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Published in: | Annals of otology, rhinology & laryngology rhinology & laryngology, 2023-03, Vol.132 (3), p.294-303 |
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container_issue | 3 |
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container_title | Annals of otology, rhinology & laryngology |
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creator | Bivona, Louis Williamson, Adrian Emery, Sanford E. Stokes, William A. |
description | Objective:
Anterior cervical discectomy and fusion is a common procedure performed by spine surgeons with rare complications and high treatment success. Late presentation of retropharyngeal abscess in patients with a history of anterior cervical discectomy and fusion is rare but can have devastating consequences. There is a paucity of data to guide medical and surgical management of retropharyngeal abscess in these patients.
Methods:
We discuss 7 patients who presented to our institution with a late retropharyngeal abscess after having a history of anterior cervical discectomy and fusion. A review and description of the current literature regarding treatment and outcomes is described.
Results:
Seven patients presented to our institution with a retropharyngeal abscess ranging from 10 months to 7 years after undergoing anterior cervical discectomy and fusion. All patients received at least a 6-week course of appropriate intravenous antibiotics. Only one patient had their initial ACDF instrumentation removed at the time of presentation for the abscess. Four out of the 7 patients were treated with irrigation and debridement in addition to intravenous antibiotics, whereas 3 patients were treated with no surgery and intravenous antibiotics alone. All patients were asymptomatic at final follow up.
Conclusions:
Late retropharyngeal abscess after anterior cervical discectomy and fusion is a rare complication. Surgical management should be considered along with long term antibiotics. Removal of implants may not be necessary for infection resolution. Antibiotic treatment alone may be indicated for patients who are not septic, do not have airway compromise, or and can be considered for poor surgical candidates. |
doi_str_mv | 10.1177/00034894221086993 |
format | article |
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Anterior cervical discectomy and fusion is a common procedure performed by spine surgeons with rare complications and high treatment success. Late presentation of retropharyngeal abscess in patients with a history of anterior cervical discectomy and fusion is rare but can have devastating consequences. There is a paucity of data to guide medical and surgical management of retropharyngeal abscess in these patients.
Methods:
We discuss 7 patients who presented to our institution with a late retropharyngeal abscess after having a history of anterior cervical discectomy and fusion. A review and description of the current literature regarding treatment and outcomes is described.
Results:
Seven patients presented to our institution with a retropharyngeal abscess ranging from 10 months to 7 years after undergoing anterior cervical discectomy and fusion. All patients received at least a 6-week course of appropriate intravenous antibiotics. Only one patient had their initial ACDF instrumentation removed at the time of presentation for the abscess. Four out of the 7 patients were treated with irrigation and debridement in addition to intravenous antibiotics, whereas 3 patients were treated with no surgery and intravenous antibiotics alone. All patients were asymptomatic at final follow up.
Conclusions:
Late retropharyngeal abscess after anterior cervical discectomy and fusion is a rare complication. Surgical management should be considered along with long term antibiotics. Removal of implants may not be necessary for infection resolution. Antibiotic treatment alone may be indicated for patients who are not septic, do not have airway compromise, or and can be considered for poor surgical candidates.</description><identifier>ISSN: 0003-4894</identifier><identifier>EISSN: 1943-572X</identifier><identifier>DOI: 10.1177/00034894221086993</identifier><identifier>PMID: 35450429</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Anti-Bacterial Agents - therapeutic use ; Cervical Vertebrae - surgery ; Deglutition Disorders - etiology ; Diskectomy - adverse effects ; Humans ; Postoperative Complications - etiology ; Retropharyngeal Abscess - diagnosis ; Retropharyngeal Abscess - etiology ; Retropharyngeal Abscess - surgery ; Spinal Fusion - adverse effects ; Treatment Outcome</subject><ispartof>Annals of otology, rhinology & laryngology, 2023-03, Vol.132 (3), p.294-303</ispartof><rights>The Author(s) 2022</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c340t-eb6963caf8c1b87b12bfa8161ad85a46a89abb155b691b1e03cd9f9dd77d1443</citedby><cites>FETCH-LOGICAL-c340t-eb6963caf8c1b87b12bfa8161ad85a46a89abb155b691b1e03cd9f9dd77d1443</cites><orcidid>0000-0001-8087-6552 ; 0000-0003-1147-5362</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,79364</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35450429$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bivona, Louis</creatorcontrib><creatorcontrib>Williamson, Adrian</creatorcontrib><creatorcontrib>Emery, Sanford E.</creatorcontrib><creatorcontrib>Stokes, William A.</creatorcontrib><title>Late Retropharyngeal and Parapharyngeal Abscess in Patients with a History of Anterior Cervical Discectomy and Fusion</title><title>Annals of otology, rhinology & laryngology</title><addtitle>Ann Otol Rhinol Laryngol</addtitle><description>Objective:
Anterior cervical discectomy and fusion is a common procedure performed by spine surgeons with rare complications and high treatment success. Late presentation of retropharyngeal abscess in patients with a history of anterior cervical discectomy and fusion is rare but can have devastating consequences. There is a paucity of data to guide medical and surgical management of retropharyngeal abscess in these patients.
Methods:
We discuss 7 patients who presented to our institution with a late retropharyngeal abscess after having a history of anterior cervical discectomy and fusion. A review and description of the current literature regarding treatment and outcomes is described.
Results:
Seven patients presented to our institution with a retropharyngeal abscess ranging from 10 months to 7 years after undergoing anterior cervical discectomy and fusion. All patients received at least a 6-week course of appropriate intravenous antibiotics. Only one patient had their initial ACDF instrumentation removed at the time of presentation for the abscess. Four out of the 7 patients were treated with irrigation and debridement in addition to intravenous antibiotics, whereas 3 patients were treated with no surgery and intravenous antibiotics alone. All patients were asymptomatic at final follow up.
Conclusions:
Late retropharyngeal abscess after anterior cervical discectomy and fusion is a rare complication. Surgical management should be considered along with long term antibiotics. Removal of implants may not be necessary for infection resolution. Antibiotic treatment alone may be indicated for patients who are not septic, do not have airway compromise, or and can be considered for poor surgical candidates.</description><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Cervical Vertebrae - surgery</subject><subject>Deglutition Disorders - etiology</subject><subject>Diskectomy - adverse effects</subject><subject>Humans</subject><subject>Postoperative Complications - etiology</subject><subject>Retropharyngeal Abscess - diagnosis</subject><subject>Retropharyngeal Abscess - etiology</subject><subject>Retropharyngeal Abscess - surgery</subject><subject>Spinal Fusion - adverse effects</subject><subject>Treatment Outcome</subject><issn>0003-4894</issn><issn>1943-572X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kE9PAyEQxYnR2PrnA3gxHL1sBZZdlmNTrTVpojE9eNsAy7Y026UCq-m3l7XVmJh4Gob5vZeZB8AVRiOMGbtFCKW04JQQjIqc8_QIDDGnaZIx8noMhv086YEBOPN-HVuaIXIKBmkWH5TwIejmImj4ooOz25Vwu3apRQNFW8Fn4cSvr7H0SnsPTRsnweg2ePhhwgoKODM-WLeDtobjNmhnrIMT7d6Niro7E3Uq2M3uy3XaeWPbC3BSi8bry0M9B4vp_WIyS-ZPD4-T8TxRKUUh0TLneapEXSgsCyYxkbUocI5FVWSC5qLgQkqcZZHDEmuUqorXvKoYqzCl6Tm42dtunX3rtA_lpt-maUSrbedLkmeUMMYoiyjeo8pZ752uy60zm3h9iVHZh13-CTtqrg_2ndzo6kfxnW4ERnvAi6Uu17Zzbbz2H8dPteqIqw</recordid><startdate>202303</startdate><enddate>202303</enddate><creator>Bivona, Louis</creator><creator>Williamson, Adrian</creator><creator>Emery, Sanford E.</creator><creator>Stokes, William A.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8087-6552</orcidid><orcidid>https://orcid.org/0000-0003-1147-5362</orcidid></search><sort><creationdate>202303</creationdate><title>Late Retropharyngeal and Parapharyngeal Abscess in Patients with a History of Anterior Cervical Discectomy and Fusion</title><author>Bivona, Louis ; Williamson, Adrian ; Emery, Sanford E. ; Stokes, William A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c340t-eb6963caf8c1b87b12bfa8161ad85a46a89abb155b691b1e03cd9f9dd77d1443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Cervical Vertebrae - surgery</topic><topic>Deglutition Disorders - etiology</topic><topic>Diskectomy - adverse effects</topic><topic>Humans</topic><topic>Postoperative Complications - etiology</topic><topic>Retropharyngeal Abscess - diagnosis</topic><topic>Retropharyngeal Abscess - etiology</topic><topic>Retropharyngeal Abscess - surgery</topic><topic>Spinal Fusion - adverse effects</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bivona, Louis</creatorcontrib><creatorcontrib>Williamson, Adrian</creatorcontrib><creatorcontrib>Emery, Sanford E.</creatorcontrib><creatorcontrib>Stokes, William A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of otology, rhinology & laryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bivona, Louis</au><au>Williamson, Adrian</au><au>Emery, Sanford E.</au><au>Stokes, William A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Late Retropharyngeal and Parapharyngeal Abscess in Patients with a History of Anterior Cervical Discectomy and Fusion</atitle><jtitle>Annals of otology, rhinology & laryngology</jtitle><addtitle>Ann Otol Rhinol Laryngol</addtitle><date>2023-03</date><risdate>2023</risdate><volume>132</volume><issue>3</issue><spage>294</spage><epage>303</epage><pages>294-303</pages><issn>0003-4894</issn><eissn>1943-572X</eissn><abstract>Objective:
Anterior cervical discectomy and fusion is a common procedure performed by spine surgeons with rare complications and high treatment success. Late presentation of retropharyngeal abscess in patients with a history of anterior cervical discectomy and fusion is rare but can have devastating consequences. There is a paucity of data to guide medical and surgical management of retropharyngeal abscess in these patients.
Methods:
We discuss 7 patients who presented to our institution with a late retropharyngeal abscess after having a history of anterior cervical discectomy and fusion. A review and description of the current literature regarding treatment and outcomes is described.
Results:
Seven patients presented to our institution with a retropharyngeal abscess ranging from 10 months to 7 years after undergoing anterior cervical discectomy and fusion. All patients received at least a 6-week course of appropriate intravenous antibiotics. Only one patient had their initial ACDF instrumentation removed at the time of presentation for the abscess. Four out of the 7 patients were treated with irrigation and debridement in addition to intravenous antibiotics, whereas 3 patients were treated with no surgery and intravenous antibiotics alone. All patients were asymptomatic at final follow up.
Conclusions:
Late retropharyngeal abscess after anterior cervical discectomy and fusion is a rare complication. Surgical management should be considered along with long term antibiotics. Removal of implants may not be necessary for infection resolution. Antibiotic treatment alone may be indicated for patients who are not septic, do not have airway compromise, or and can be considered for poor surgical candidates.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>35450429</pmid><doi>10.1177/00034894221086993</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8087-6552</orcidid><orcidid>https://orcid.org/0000-0003-1147-5362</orcidid></addata></record> |
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issn | 0003-4894 1943-572X |
language | eng |
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source | Sage Journals Online |
subjects | Anti-Bacterial Agents - therapeutic use Cervical Vertebrae - surgery Deglutition Disorders - etiology Diskectomy - adverse effects Humans Postoperative Complications - etiology Retropharyngeal Abscess - diagnosis Retropharyngeal Abscess - etiology Retropharyngeal Abscess - surgery Spinal Fusion - adverse effects Treatment Outcome |
title | Late Retropharyngeal and Parapharyngeal Abscess in Patients with a History of Anterior Cervical Discectomy and Fusion |
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