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

2021 ◽  
pp. 219256822110057
Author(s):  
Lucia Moletta ◽  
Elisa Sefora Pierobon ◽  
Renato Salvador ◽  
Francesco Volpin ◽  
Francesco Massimiliano Finocchiaro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Esophageal Perforation ◽  
English Literature ◽  
Case Series ◽  
Review Of The Literature ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Fixation Devices

Study Design: Case series and systematic review of the Literature. Objectives: Pharyngo-esophageal perforation (PEP) is a rare, life-threatening complication of anterior cervical spine surgery (ACSS). Best management of these patients remains poorly defined. The aim of this study is to present our experience with this entity and to perform a systematic Literature review to better clarify the appropriate treatment of these patients. Methods: Patients referred to our center for PEP following ACSS (January 2002-December 2018) were identified from our database. Moreover, an extensive review of the English Literature was conducted according to the 2009 PRISMA guidelines. Results: Twelve patients were referred to our Institution for PEP following ACSS. Indications for ACSS were trauma (n = 10), vertebral metastases (n = 1) and disc herniation (n = 1). All patients underwent hardware placement at the time of ACSS. There were 6 early and 6 delayed PEP. Surgical treatment was performed in 11 patients with total or partial removal of spine fixation devices, autologous bone graft insertion or plate/cage replacement, anatomical suture of the fistula and suture line reinforcement with myoplasty. Complete resolution of PEP was observed in 6 patients. Five patients experienced PEP persistence, requiring further surgical management in 2 cases. At a median follow-up of 18.8 months, all patients exhibited permanent resolution of the perforation. Conclusions: PEP following ACSS is a rare but dreadful complication. Partial or total removal of the fixation devices, direct suture of the esophageal defect and coverage with tissue flaps seems to be an effective surgical approach in these patients

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

2016 ◽  
Vol 25 (3) ◽  
pp. 285-291 ◽  
Author(s):  
Sameer H. Halani ◽  
Griffin R. Baum ◽  
Jonathan P. Riley ◽  
Gustavo Pradilla ◽  
Daniel Refai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Esophageal Perforation ◽  
Spinal Surgery ◽  
Esophageal Injury ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Pubmed Search ◽  
Anterior Spinal Surgery

OBJECTIVE Esophageal perforation is a rare but well-known complication of anterior cervical spine surgery. The authors performed a systematic review of the literature to evaluate symptomatology, direct causes, repair methods, and associated complications of esophageal injury. METHODS A PubMed search that adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines included relevant clinical studies and case reports (articles written in the English language that included humans as subjects) that reported patients who underwent anterior spinal surgery and sustained some form of esophageal perforation. Available data on clinical presentation, the surgical procedure performed, outcome measures, and other individual variables were abstracted from 1980 through 2015. RESULTS The PubMed search yielded 65 articles with 153 patients (mean age 44.7 years; range 14–85 years) who underwent anterior spinal surgery and sustained esophageal perforation, either during surgery or in a delayed fashion. The most common indications for initial anterior cervical spine surgery in these cases were vertebral fracture/dislocation (n = 77), spondylotic myelopathy (n = 15), and nucleus pulposus herniation (n = 10). The most commonly involved spinal levels were C5–6 (n = 51) and C6–7 (n = 39). The most common presenting symptoms included dysphagia (n =63), fever (n = 24), neck swelling (n = 23), and wound leakage (n = 18). The etiology of esophageal perforation included hardware failure (n = 31), hardware erosion (n = 23), and intraoperative injury (n = 14). The imaging modalities used to identify the esophageal perforations included modified contrast dye swallow studies, CT, endoscopy, plain radiography, and MRI. Esophageal repair was most commonly achieved using a modified muscle flap, as well as with primary closure. Outcomes measured in the literature were often defined by the time to oral intake following esophageal repair. Complications included pneumonia (n = 6), mediastinitis (n = 4), osteomyelitis (n = 3), sepsis (n = 3), acute respiratory distress syndrome (n = 2), and recurrent laryngeal nerve damage (n = 1). The mortality rate of esophageal perforation in the analysis was 3.92% (6 of 153 reported patients). CONCLUSIONS Esophageal perforation after anterior cervical spine surgery is a rare complication. This systematic review demonstrates that these perforations can be stratified into 3 categories based on the timing of symptomatic onset: intraoperative, early postoperative (within 30 days of anterior spinal surgery), and delayed. The most common source of esophageal injury is hardware erosion or migration, each of which may vary in their time to symptomatic manifestation.

scholarly journals Esophageal Perforation Following Anterior Cervical Spine Surgery: Case Report and Review of the Literature

2017 ◽  
Vol 7 (1_suppl) ◽  
pp. 28S-36S ◽  
Author(s):  
Stuart H. Hershman ◽  
William A. Kunkle ◽  
Michael P. Kelly ◽  
Jacob M. Buchowski ◽  
Wilson Z. Ray ◽  
...  
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Esophageal Perforation ◽  
Review Of The Literature ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery

Esophageal Perforation Associated with Cervical Spine Surgery: Report of Two Cases and Review of the Literature

2004 ◽  
Vol 21 (3) ◽  
pp. 246-249 ◽  
Author(s):  
B.C. Vrouenraets ◽  
H.D. Been ◽  
R. Brouwer-Mladin ◽  
M. Bruno ◽  
J.J.B. van Lanschot
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Esophageal Perforation ◽  
Review Of The Literature ◽  
Cervical Spine Surgery

Recurrent esophageal perforation after anterior cervical spine surgery: case report

2018 ◽  
Vol 27 (S3) ◽  
pp. 515-519 ◽  
Author(s):  
Man-Kyu Park ◽  
Dae-Chul Cho ◽  
Woo-Seok Bang ◽  
Kyoung-Tae Kim ◽  
Joo-Kyung Sung
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Esophageal Perforation ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery

Esophageal Perforation Following Anterior Cervical Spine Surgery

Spine ◽  
1989 ◽  
Vol 14 (10) ◽  
pp. 1051-1053 ◽  
Author(s):  
KENNETH E. NEWHOUSE ◽  
RONALD W. LINDSEY ◽  
CHARLES R. CLARK ◽  
JONAS LIEPONIS ◽  
MICHAEL J. MURPHY
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Esophageal Perforation ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery

scholarly journals Effect of perioperative steroids on dysphagia after anterior cervical spine surgery: A systematic review

10.14444/4009 ◽  
2017 ◽  
Vol 11 (2) ◽  
pp. 9 ◽  
Author(s):  
Abidemi S. Adenikinju ◽  
Sameer H. Halani ◽  
Rima S. Rindler ◽  
Matthew F. Gary ◽  
Keith W. Michael ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery

scholarly journals Frequency, recognition, and management of postoperative hematomas following anterior cervical spine surgery: A review

2020 ◽  
Vol 11 ◽  
pp. 356
Author(s):  
Nancy Epstein
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Early Recognition ◽  
Case Reports ◽  
Case Series ◽  
Improvement Program ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Cervical Surgery ◽  
Anterior Corpectomy

Background: We reviewed the frequency, recognition, and management of postoperative hematomas (HT) (i.e. retropharyngeal [RFH], wound [WH], and/or spinal epidural hematomas [SEH]) following anterior cervical discectomy/fusion (ACDF), anterior corpectomy fusion (ACF), and/or anterior cervical spine surgery (ACSS). Methods: Postoperative cervical hematomas following ACDF, ACF, and ACSS ranged from 0.4% to 1.2% in a series of 11 studies involving a total of 44, 030 patients. These included; 4 single case reports, 2 small case series (6 and 30 cases), 4 larger series (758–2375 for a total of 6729 patients), an a large NSQUIP (National Surgical Quality Improvement Program ) Database involving 37,261 ACDF patients. Results: Risk factors contributing to postoperative cervical hematomas included; DISH (diffuse idiopathic skeletal hyperostosis), ossification of the posterior longitudinal ligament (OPLL), therpeutic heparin levels, longer operative times, multilevel surgery, ASA Scores of +/= 3, (American Society of Anesthesiologists), prone surgery, operative times > 4 hours, smoking, higher/lower body mass index (BMI), anemia, age >65, > medical comorbidities, and male gender. Notably, the use of drains did not prevent HT, and did not increase the infection, or reoperation rates. Conclusion: In our review of 11 studies focused on anterior cervical surgery, the incidence of postoperative hematomas ranged from 0.4 to 1.2%. Early recognition of these postoperative hemorrhages, and appropriate management (surgical/non-surgical) are critical to optimize recovery, and limit morbidity, and mortality.

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