Management of the cervical esophagus and hypofarinx perforations complicating anterior cervical spine surgery

Five cases of esophageal or pharyngeal perforation diagnosed during or after anterior cervical spine surgery are presented. To outline a protocol for the early diagnosis and treatment of iatrogenic pharyngoesophageal perforations. Pharyngoesophageal perforations after anterior cervical spine surgery...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2003-08, Vol.28 (15), p.E290-E295
Main Authors: Orlando, Epimenio Ramundo, Caroli, Emanuela, Ferrante, Luigi
Format: Article
Language:English
Subjects:
Bone Screws - adverse effects
Cervical Vertebrae - surgery
Decompression, Surgical - adverse effects
Esophageal Perforation - diagnosis
Esophageal Perforation - etiology
Esophageal Perforation - therapy
Female
Fistula - diagnosis
Fistula - etiology
Fistula - surgery
Foreign-Body Migration - complications
Foreign-Body Migration - diagnosis
Foreign-Body Migration - diagnostic imaging
Humans
Hypopharynx - injuries
Intervertebral Disc Displacement - surgery
Male
Middle Aged
Neck - surgery
Postoperative Complications - diagnosis
Postoperative Complications - etiology
Postoperative Complications - therapy
Radiography
Reoperation
Spinal Fusion - adverse effects
Surgical Wound Infection - diagnosis
Surgical Wound Infection - etiology
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Summary:Five cases of esophageal or pharyngeal perforation diagnosed during or after anterior cervical spine surgery are presented. To outline a protocol for the early diagnosis and treatment of iatrogenic pharyngoesophageal perforations. Pharyngoesophageal perforations after anterior cervical spine surgery are uncommon or rarely reported complications. They may have serious functional consequences, including death, if they are not diagnosed promptly and treated effectively. These potentially fatal conditions require a surgical and medical therapy. Clinical course, diagnostic tools and guidelines for the management of five patients presenting esophagopharingeal perforations are illustrated. These five cases resulted in definitive healing of the laceration without functional consequences. We believe that awareness of these complications and their causes, prompt recognition of the symptoms and immediate and multimodality therapies are essential tools to achieve successful results.
ISSN:0362-2436
1528-1159
DOI:10.1097/01.brs.0000087093.89889.0a