Successful surgical management of a delayed pharyngo-esophageal perforation after anterior cervical spine plating.
A case report of a 41-year-old man who had a delayed pharyngo-esophageal perforation without instrumentation failure 7 years after anterior cervical spine plating is presented and the literature on this issue is reviewed. This injury resulted from repetitive friction/traction between the retropharyngo-esophageal wall and the cervical plate construct leading to a pseudodiverticulum and perforation. Successful treatment of the perforation was obtained after surgical repair using a sternocleidomastoid muscle flap. This case stresses the necessity of careful long-term follow-up in patients with anterior cervical spine plating for early detection of possible perforation and the use of muscle flap as the treatment of choice during surgical repair.
Solerio
Dino
D
General Surgery 3, San Giovanni Battista Hospital, University of Turin, via Genova 3, 10126, Turin, Italy. soleriod@libero.it
Ruffini
Enrico
E
Gargiulo
Giosué
G
Camandona
Michele
M
Raggio
Eleonora
E
Solini
Antonio
A
Dei Poli
Marcello
M
D000038:Abscess / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D001860:Bone Plates / Q000009:adverse effects*; D002574:Cervical Vertebrae / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D044964:Cervicoplasty / Q000379:methods; D019299:Decompression, Surgical / Q000009:adverse effects; D003680:Deglutition Disorders / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D042241:Early Diagnosis; D004947:Esophagus / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D005402:Fistula / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D009334:Neck Muscles / Q000601:surgery; D010614:Pharynx / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D012086:Reoperation; D016103:Spinal Fractures / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D013524:Surgical Flaps; D016896:Treatment Outcome