Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지

Esophageal Injury Following Anterior Cervical Plate Fixation

  • Park, Jae-Sung (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Kim, Young-Baeg (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Hong, Hyun-Jong (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Hwang, Sung-Nam (Department of Neurosurgery, College of Medicine, Chung-Ang University)
  • Published : 2005.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

We report five patients of esophageal injuries confirmed by clinical signs and radiological evidences. They include a partial tear and a perforation which were not noticed during the operation, a perforation which was primarily repaired during the operation, and two perforations which occurred during the reoperations for the removal of mal-positioned screws or plate. The partial tear was not repaired. The perforation which occurred during the operation was primarily sutured and didn't receive further treatment. Two perforations which occurred during the reoperations were treated by irrigation, debridement with surgical drainage, and systemic antiobiotics. One who was diagnosed later after the operation showed the poorest outcome and required longest hospital days among our series. Early detection and appropriate treatment of esophageal injury following anterior spinal surgery can only improve the prognosis by preventing secondary complications.

Keywords

References

  1. Balmaseda MT, Pellioni DJ : Esophagocutaneous fistula in spinal cord injury : a complication of anterior cervical fusion. Arch Phys Med Rehabil 66 : 783-784, 1985
  2. Beal SL, Pottmeyer EW, Spisso JM : Esophageal perforation following external blunt trauma. J Trauma 28 : 1425-1432, 1988 https://doi.org/10.1097/00005373-198810000-00003
  3. Bohlman HH : Complications of treatment of fracture dislocations of the cervical spine : Complications in orthopedic surgery, Vol. 2. ed by CH epps, New York, JB Lippincott, 1978, pp622-623
  4. Borowiecki B, Charow A, Cook W : An unusual football injury. Arch Otolaryngol 95 : 185-187, 1973
  5. Bose B : Anterior cervical fusion using Caspar plating : Analysis of results and review of the literature. Surg Neurol 49 : 25-31, 1998 https://doi.org/10.1016/S0090-3019(97)00306-6
  6. Caspar W, Barbier DD, Klara PM : Anterior cervical fusion and Caspar plate stabilization for cervical trauma. Neurosurgery 25 : 491-502, 1989 https://doi.org/10.1097/00006123-198910000-00001
  7. English GM, Hsu S, Edgar R, Gibson-Eccles M : Oesophageal trauma in patients with spinal cord injury. Paraplegia 30 : 903-912, 1992 https://doi.org/10.1038/sc.1992.167
  8. Geyer TE, Foy MA : Oral extrusion of a screw after anterior cervical spine plating. Spine 26 : 1814-1816, 2001 https://doi.org/10.1097/00007632-200108150-00019
  9. Graham JJ : Complications of cervical spine surgery : a five year report on the survey of the membership of the Cervical Spine Research Society by the Morbidity and Mortality Committee. Spine 14 : 1046-1050, 1989 https://doi.org/10.1097/00007632-198910000-00003
  10. Gaudinez RF, English GM, Gebhard JS, Brugman JL, Donalson DH, Brown CW : Esophageal perforations after anterior cervical surgery. J Spinal Disord 13 : 77-84, 2000 https://doi.org/10.1097/00002517-200002000-00015
  11. Johnson KG, Hood DD : Esophageal perforation associated with endotracheal intubation. Anaesthesiology 64 : 281-283, 1986 https://doi.org/10.1097/00000542-198602000-00031
  12. Kuriloff DB, Blaugrund S, Ryan J, O'Leary P : Delayed neck infection following anterior spine surgery. Laryngoscope 97 : 1094-1098, 1987 https://doi.org/10.1288/00005537-198709000-00017
  13. Lee CH, Kim ES, Choi JY, Park YG, Baek SH, Park IS, et al : Surgical treatment of Esophago-Cutaneous fistula developing after anterior cervical spine surgery : case report. J Korean Neurosurg Soc 27 : 246-250, 1998
  14. Lerschlolarn L, Banchuin TD : Cervical esophageal perforation from external blunt trauma. South Med J 74 : 254-255, 1981 https://doi.org/10.1097/00007611-198102000-00040
  15. Newhouse KE, Lindsey RW, Clark CR, Lieponis J, Murphy MJ : Esophageal perforation following anterior cervical spine surgery. Spine 14 : 1051-1053, 1989 https://doi.org/10.1097/00007632-198910000-00004
  16. Quintana R, Bartley TD, Wheat MW Jr : Esophageal perforation : analysis of 10 cases. Ann Thorac Surg 10 : 45-53, 1970 https://doi.org/10.1016/S0003-4975(10)65564-6
  17. Ripa DR, Kowall MG, Meryer PR : Series of ninety-two traumatic cervical spine injuries stabilized with anterior ASIF plate fusion technique, Spine 16 : 46-55, 1991 https://doi.org/10.1097/00007632-199103001-00009
  18. Smith MD, Bolesta MJ : Esophageal perforation after anterior cervical plate fixation : a report of two cases. J Spinal Disord 5 : 357-362, 1992 https://doi.org/10.1097/00002517-199209000-00015
  19. Splener CW, Benfield JR : Esophageal disruption from blunt and penetrating external trauma. Arch Surg 111 : 663-667, 1976 https://doi.org/10.1001/archsurg.1976.01360240043007
  20. Stringer WL, Kelly DL, Johnston FR, Holliday RH : Hyperextension injury of the cervical spine with esophageal perforation. Case report : J Neurosurg 53 : 541-543, 1980 https://doi.org/10.3171/jns.1980.53.4.0541
  21. Tomaszek DE, Rosner MJ : Occult esophageal perforation associated with cervical spine fracture. Neurosurgery 14 : 492-494, 1984 https://doi.org/10.1097/00006123-198404000-00019
  22. White CS, Templeton PA, Attar S : Esophageal perforation : CT findings. Am J Roentgenol 160 : 767-770, 1993 https://doi.org/10.2214/ajr.160.4.8456662
  23. Whitehill R, Sirna EC, Young DC, Cantrell RW : Late esophageal perforation from an autogenous bone graft. A report of a case. J Bone Joint Surg 67A : 644-645, 1985
  24. Wolff AP, Kuhn FA, Ogura JH : Pharyngeal-esophageal perforations associated with rapid oral endotracheal intubation. Ann Otol Rhinol Laryngol 81 : 258-261, 1972 https://doi.org/10.1177/000348947208100213
  25. Yee GK, Terry AF : Oesophageal penetration by and anterior cervical fixation device : a case report. Spine 18 : 522-527, 1993 https://doi.org/10.1097/00007632-199303010-00018
  26. Zeidman SM, Ducker TB, Raycroft J : Trends and complications in cervical spine surgery : 1989-1993. J Spinal Disord 10 : 523-526, 1997