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Case Reports
. 2013 Oct;3(4):276-8.
doi: 10.4103/2229-5151.124164.

Esophageal perforation following cervical spine surgery: A review with considerations in airway management

Hassan H Amhaz  1 , Ruth Kuo  1 , Rahul Vaidya  2 , Marc S Orlewicz  1
Affiliations
Case Reports

Esophageal perforation following cervical spine surgery: A review with considerations in airway management

Hassan H Amhaz et al. Int J Crit Illn Inj Sci. 2013 Oct.

Abstract

Anterior cervical discectomy and fusion (ACDF) is a commonly performed surgery for the treatment of spondylosis, radiculopathy, myelopathy, and trauma to the cervical spine. Esophageal perforation is a rare yet serious complication following ACDF with an incidence of 0.02 to 1.52%. We describe a case of a 24-year-old man who underwent ACDF and corpectomy following a motor vehicle accident who subsequently developed delayed onset esophageal perforation requiring surgical intervention. We believe that the detailed review of the surgical management of esophageal perforation following cervical spine surgery will provide a deeper understanding for the Intensivist in regards to postoperative airway management in these types of patients. Careful extubation over a soft flexible exchange catheter should take place to help reduce the risk of perforation in the event reintubation is required.

Keywords: Airway management; anterior cervical discectomy and Fusion; corpectomy; esophageal perforation.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Lateral cervical x-ray shows C4-T1 posterior fusion with C5-C7 ACDF and PEEK cage at the level of C6 with no apparent hardware defects (a) CT neck demonstrated air surrounding the implant at C6 as well as the anterior fusion plate (b) Barium swallow study showed a posterior esophageal barium leak at C5-C6 and a TE-fistula. The contents of the fistula are seen tracking inferiorly T1 and is seen anterior to the fusion plate (c) Barium swallow study done ten days postoperatively shows resolution of perforation (d)
Figure 2
Figure 2
Intraoperative video-assisted laryngoscopic view revealing the anterior cervical plate within the pharyngoesophagus
See this image and copyright information in PMC

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