Esophageal, pharyngeal and hemorrhagic complications occurring in anterior cervical surgery: Three illustrative cases.
BACKGROUND
The number of esophageal and pharyngeal perforations occurring in anterior cervical surgeries ranges from 0.25% to 1% and 0.2% to 1.2%, respectively. Symptoms usually appear postoperatively and are attributed to: Local infection, fistula, sepsis, or mediastinitis. Acute postoperative hematoma, although very rare (<1%), is the first complication to rule out due to its life-threatening complications (e.g. acute respiratory failure).


METHODS
Over a 36-year period, the author(s) described three severe esophageal/pharyngeal complications attributed to anterior cervical surgery. As these complications were appropriately recognized/treated, patients had favorable outcomes.


CONCLUSIONS
Anterior cervical spine surgery is a safe approach and is associated with few major esophageal/pharyngeal complications, which most commonly include transient dysphagia and dysphonia. If symptoms persist, patients should be assessed for esophageal/pharyngeal defects utilizing appropriate imaging studies. Notably, even if the major complications listed above are adequately treated, optimal results are in no way guaranteed.
Neurosurgery Division Hospital Clínico Universitario "Lozano Blesa" de Zaragoza, Avenida San Juan Bosco 1550009 Zaragoza, Zaragoza, ESPAÑA, Spain.
Víctor Rodrigo
VR
Paradells
Neurosurgery Division Hospital Clínico Universitario "Lozano Blesa" de Zaragoza, Avenida San Juan Bosco 1550009 Zaragoza, Zaragoza, ESPAÑA, Spain.
Juan Bosco Calatayud
JB
Pérez
Neurosurgery Division Hospital Clínico Universitario "Lozano Blesa" de Zaragoza, Avenida San Juan Bosco 1550009 Zaragoza, Zaragoza, ESPAÑA, Spain.
Francisco Javier Díar
FJ
Vicente
Neurosurgery Division Hospital Clínico Universitario "Lozano Blesa" de Zaragoza, Avenida San Juan Bosco 1550009 Zaragoza, Zaragoza, ESPAÑA, Spain.
Luciano Bances
LB
Florez
Neurosurgery Division Hospital Clínico Universitario "Lozano Blesa" de Zaragoza, Avenida San Juan Bosco 1550009 Zaragoza, Zaragoza, ESPAÑA, Spain.
Marta Claramonte
MC
de la Viuda
Neurosurgery Division Hospital Clínico Universitario "Lozano Blesa" de Zaragoza, Avenida San Juan Bosco 1550009 Zaragoza, Zaragoza, ESPAÑA, Spain.
Francisco Javier
FJ
Villagrasa
Anterior cervical approach; complications; esophageal fistula; pharyngeal fistula; postoperative hematoma; respiratory decompensation