title: Oesophageal perforation caused by screw displacement 16 months following anterior cervical spine fixation.
abstract: Anterior cervical spine plating is a standard procedure for fixing unstable vertebral fractures. Following surgery, oesophageal perforation has an incidence of 0.25% and this is usually hours following surgery, due to over prominent screws or friction between the oesophagus and the plate. Instrumentation failure of these plates months or years following surgery is very rare but potentially life-threatening. We report a case of microcytic anaemia which was investigated by oesophagogastroduodenoscopy, and subsequently found that a screw from the anterior plate had lifted off and perforated the oesophagus. This is very rare, but emphasises an important lesson. Anyone presenting with gastrointestinal bleeding or infectious signs, with a history of cervical spine plating should be investigated immediately for instrumentation failure as it brings a high mortality.
authors: Medical School, University of Liverpool, Liverpool, UK.
authors: Nicholas
authors: N
authors: Leaver
authors: Countess of Chester Hospital, Chester, UK.
authors: Alexandra
authors: A
authors: Colby
authors: Countess of Chester Hospital, Chester, UK.
authors: Nathan
authors: N
authors: Appleton
authors: Countess of Chester Hospital, Chester, UK.
authors: Dale
authors: D
authors: Vimalachandran
mesh_terms: D000740:Anemia / Q000175:diagnosis / Q000209:etiology*; D001860:Bone Plates; D001863:Bone Screws / Q000009:adverse effects*; D002574:Cervical Vertebrae / Q000601:surgery*; D003113:Colonoscopy; D004939:Esophageal Perforation / Q000150:complications / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013123:Spinal Fusion / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed