title: Late prevertebral abscess after anterior cervical fusion.
abstract: METHODS
  We present a unique case of a 54-year-old woman who developed a prevertebral abscess 2 years after anterior cervical fusion in the absence of previously reported risk factors for late infection. The literature relevant to this topic is reviewed.
  
  
  OBJECTIVE
  To report a rare complication of a commonly performed surgery.
  
  
  BACKGROUND
  Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed spinal surgeries. The complication rate is relatively low; the risk of infection is only 0.1% to 1.6%. In the late postoperative setting, more than 6 months, wound infections are very rare and are often associated with an esophageal perforation secondary to hardware migration.
  
  
  METHODS
  We present a rare complication of a deep wound infection in a 54-year-old woman 2 years after an anterior cervical fusion. On serial radiograph imaging after surgery, the surgical level demonstrated progressive fusion. At 2 years, however, the patient presented with acute dysphagia. Computed tomography (CT) of the neck with contrast demonstrated a rim enhancing prevertebral mass, which was treated with wound exploration and debridement. Direct laryngoscopy at the time of surgery did not demonstrate a breach in the esophageal mucosa and inspection of the esophagus during surgery did not reveal a diverticulum, tear, or breach in the esophagus.
  
  
  RESULTS
  After surgical exploration and debridement the patient was placed on a 6-week course of antibiotics. Her dysphagia improved significantly after debridement of the prevertebral abscess.
  
  
  CONCLUSIONS
  Late occurring, deep wound infections are a rare complication of anterior cervical fusion. Dysphagia in the late postoperative setting should be considered carefully and evaluated for esophageal perforation or deep wound infection.
authors.affiliation: Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA. lana.christiano@gmail.com
authors.forename: Lana D
authors.initials: LD
authors.lastname: Christiano
authors.forename: Ira M
authors.initials: IM
authors.lastname: Goldstein
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D002574:Cervical Vertebrae / Q000601:surgery*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D013123:Spinal Fusion / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D013997:Time Factors