CC BY-NC-ND 4.0 · Indian Journal of Neurotrauma 2020; 17(01): 33-36
DOI: 10.1055/s-0040-1713349
Review Article

Esophageal Fistula following Anterior Cervical Discectomy and Fusion in Traumatic Cervical Injury Cases: A Review

Rajesh K. Meena
1   Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
,
Ramesh S. Doddamani
1   Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
,
Dattaraj P. Sawarkar
1   Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
,
Pankaj K. Singh
1   Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
,
Deepak Agarwal
1   Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations
Funding Information None.
Financial Support No financial support or grants.

Abstract

Background Esophageal fistula is a very rare complication associated with anterior approaches to the cervical spine. Timely diagnosis and early intervention are associated with favorable outcomes. There is a dilemma in the literature for its optimal management. In this review article, we will discuss the management dilemmas in patients with esophageal perforation along with an illustrative case.

Material and Methods A 24-year-old male patient operated for C5–6 fracture dislocation, presented with esophageal fistula 1 month after surgery. Investigations were done to localize the site of fistula but definitive site of leak could not be identified. Patient was counselled regarding possible surgical intervention; however, patient was opted for conservative treatment.

Conclusion Esophageal fistula is a very rare occurrence. Because of varied clinical presentation and frequent delay in diagnosis, a very high index of suspicion should always be kept in mind while evaluating a patient postoperatively for dysphagia. Timely diagnosis and early intervention are key to a successful outcome.



Publication History

Article published online:
11 August 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References

  • 1 Dakwar E, Uribe JS, Padhya TA, Vale FL. Management of delayed esophageal perforations after anterior cervical spinal surgery. J Neurosurg Spine 2009; 11 (03) 320-325
  • 2 Halani SH, Baum GR, Riley JP. et al. Esophageal perforation after anterior cervical spine surgery: a systematic review of the literature. J Neurosurg Spine 2016; 25 (03) 285-291
  • 3 Lee TS, Appelbaum EN, Sheen D, Han R, Wie B. Esophageal perforation due to anterior cervical spine hardware placement: case series. Int J Otolaryngol 2019; 2019: 7682654
  • 4 Krishnan P, Kartikueyan R, Patel SM, Bose PP, Mukherjee KK. Two cases of esophageal injury following anterior cervical discectomy and fusion: one overt and one covert. Ann Neurosci 2017; 24 (02) 126-130
  • 5 Yang S-Y, Lee S-B, Cho K-S. Delayed esophagus perforation after anteriorcervical spine surgery. Korean J Neurotrauma 2015; 11 (02) 191
  • 6 Tasiou A, Giannis T, Brotis AG. et al. Anterior cervical spine surgery-associated complications in a retrospective case-control study. J Spine Surg 2017; 3 (03) 444-459
  • 7 Paradells VR, Pérez JB, Vicente FJ, Florez LB, de la Viuda MC, Villagrasa FJ. Esophageal, pharyngeal and hemorrhagic complications occurring in anterior cervical surgery: Three illustrative cases. Surg Neurol Int 2014; 5 (04) (Suppl. 03) S126-S130
  • 8 Patel NP, Wolcott WP, Johnson JP. et al. Esophageal injury associated with anterior cervical spine surgery. Surg Neurol 2008; 69 (01) 20-24, 24
  • 9 Perrone O, Tassi V, Mattioli B. et al. Pharyngo-oesophageal perforation following anterior cervical discectomy and fusion: management and results. Eur J Cardiothorac Surg 2017; 51 (01) 160-168
  • 10 Darbari A, Suryavanshi A, Tandon S, Chandra G, Singh PK. Non malignant tracheo-esophageal fistula: Our experience. Indian J Thorac Cardiovasc Surg 2005; 21 (04) 272-276
  • 11 Newhouse KE, Lindsey RW, Clark CR, Lieponis J, Murphy MJ. Esophageal perforation following anterior cervical spine surgery. Spine 1989; 14 (10) 1051-1053
  • 12 Dabija MG, Iliescu BF, Andronic D, Popescu C, Ianovici N. Rare complication of the cervical spine trauma–traumatic esophageal fistula: case report and review of the literature. Rev Med Chir Soc Med Nat Iasi 2014; 118 (03) 683-687
  • 13 Phommachanh V, Patil YJ, McCaffrey TV, Vale F, Freeman TB, Padhya TA. Otolaryngologic management of delayed pharyngoesophageal perforation following anterior cervical spine surgery. Laryngoscope 2010; 120 (05) 930-936
  • 14 Sharma RR, Sethu AU, Lad SD, Turel KE, Pawar SJ. Pharyngeal perforation and spontaneous extrusion of the cervical graft with its fixation device: a late complication of C2-C3 fusion via anterior approach. J Clin Neurosci 2001; 8 (05) 464-468
  • 15 Solerio D, Ruffini E, Gargiulo G. et al. Successful surgical management of a delayed pharyngo-esophageal perforation after anterior cervical spine plating. Eur Spine J 2008; 17 (Suppl. 02) S280-S284
  • 16 Volkow-Fernández P, Islas-Muñoz B, Santillán-Doherty P, Estrada-Lobato E, Alva-López L, Ávila-Ramírez J. Successive complications after anterior cervical fixation: pharyngoesophageal diverticulum, fistulization, and cervical spondylitis by Streptococcus milleri - case report and literature review. J Med Case Reports 2019; 13 (01) 129
  • 17 Wang J, Shi L, Chen H, Yuan W. Esophageal Perforation in a Cervical Fracture Patient With Progressed Ankylosing Spondylitis: Case Report and Review of the Literature. Spine 2016; 41 (22) E1364-E1367 Review
  • 18 Yuan H, Ding H, Hu L, Buser Z, Zhao H, Li X. Treatment for early postoperative esophageal fistula complicated with anterior cervical surgery. J Orthop Surg (Hong Kong) 2017; 25 (01) 2309499016684418
  • 19 Al-Mourgi M. Sternocleidomastoid flap for repair of pharyngocutaneous fistula following anterior cervical spine surgery. Saudi J Health Sci 2015; 4 (03) 199