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Case Reports
. 2020 Feb 28:11:32.
doi: 10.25259/SNI_46_2020. eCollection 2020.

The new onset of dysphagia four years after anterior cervical discectomy and fusion: Case report and literature review

Darius Ansari  1   2 , Halle E K Burley  1   3 , Alexander von Glinski  1   4   5   6 , Christopher Elia  4   7 , Jens R Chapman  4 , Rod J Oskouian  1   4
Affiliations
Case Reports

The new onset of dysphagia four years after anterior cervical discectomy and fusion: Case report and literature review

Darius Ansari et al. Surg Neurol Int. .

Abstract

Background: Dysphagia is a common complication immediately following anterior cervical spine surgery. However, its onset more than 1-year postoperatively is rare.

Case description: A 45-year-old male initially underwent a C3-4 and C5-6 anterior cervical discectomy and fusion (ACDF). At age 49, 4 years later, he presented with worsening dysphagia accompanied by neck and right upper extremity pain. Radiographs demonstrated an extruded left C3 screw, which had migrated into the prevertebral soft tissues at the C4-C5 level; there was also loosening of the right C3 screw. The subsequent barium swallow study revealed that the screw was embedded in the pharyngeal wall. The patient required a two-stage operation; first, to remove the anterior instrumentation, and second, to perform a posterior instrumented C2-T2 fusion.

Conclusion: A barium swallow study and other dynamic imaging are a valuable component of the diagnostic workup and therapeutic intervention to evaluate the delayed onset dysphagia following an ACDF.

Keywords: Anterior cervical discectomy and fusion; Complications; Delayed onset dysphagia; Hardware failure.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Lateral (left) and anterior-posterior (right) X-ray views reveal an extruded left C3 screw within the prevertebral tissue.
See this image and copyright information in PMC

References

    1. Anderson KK, Arnold PM. Oropharyngeal dysphagia after anterior cervical spine surgery: A review. Global Spine J. 2013;3:273–86. - PMC - PubMed
    1. Christiano LD, Goldstein IM. Late prevertebral abscess after anterior cervical fusion. Spine (Phila Pa 1976) 2011;36:E798–802. - PubMed
    1. Fryer C, Tan HE, Bakmeedeniya R, Friedland PL. Late-onset dysphagia from hardware migration after anterior cervical discectomy and fusion: An unusual cause and review of literature. Clin Med Insights Ear Nose Throat. 2019;12:1179550619881131. - PMC - PubMed
    1. Lee MJ, Bazaz R, Furey CG, Yoo J. Risk factors for dysphagia after anterior cervical spine surgery: A two-year prospective cohort study. Spine J. 2007;7:141–7. - PubMed
    1. Min Y, Kim WS, Kang SS, Choi JM, Yeom JS, Paik NJ. Incidence of dysphagia and serial videofluoroscopic swallow study findings after anterior cervical discectomy and fusion: A prospective study. Clin Spine Surg. 2016;29:E177–81. - PubMed

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