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2019, Number 1

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Rev Fac Med UNAM 2019; 62 (1)

Management of a late esophageal perforation secondary to an anterior cervical spine surgery

Calvo VI, Santander FSA, González VP, Rodríguez RB, Escamilla RR, Palacios MR
Full text How to cite this article

Language: Spanish
References: 11
Page: 27-32
PDF size: 632.25 Kb.


Key words:

Esophageal perforation, VAC system, cervical spine.

ABSTRACT

Introduction: The anterior cervical spine surgery is a routine procedure for the fixation of unstable vertebral fractures; the indications for stabilization of the vertebrae are osteomyelitis, spinal tumors and trauma.
Objective: To inform about one of the rare and potentially dangerous complications of the cervical spine fixation by anterior approach.
Patients and methods: CASE 1: A 41 year-old male patient who had a car accident. The tomography shows a fracture of the anterior arch of C1 and a spinous process fracture of C5-C6. He underwent surgery, and osteosynthesis with plate fixation was placed. A month later he presented esophageal perforation, and underwent surgery again. Osteosynthesis was removed, drainage was performed and a VAC system was placed. He was discharged by adequate evolution. CASE 2: A 53 year-old female patient, began her condition a month earlier with cervicodorsal pain. A magnetic resonance was performed finding disc herniation C4-C5, C5-C6. An arthroplasty with prosthesis in C4-C5 was performed. Five months later, she presented migration of the prosthetic implant and underwent surgery again to remove the prosthesis, presenting esophageal perforation. The surgical wound was washed and a VAC system was placed with satisfactory evolution.
Results: A cervical perforation after an anterior cervical spine surgery is a rare complication; an early diagnosis is crucial.


REFERENCES

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  3. Zdichavsky M, Blauth M, Bosch U. Late esophageal perforation complicating anterior cervical plate fixation in ankylosing spondylitis: a case report and review of the literature. Arch Orthop Trauma Surg. 2004;124:349-53.

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Rev Fac Med UNAM . 2019;62