No abstract

Isocentric 3-dimensional fluoroscopy, in conjunction with an image-guided navigational software system, obviates the need for cumbersome biplanar fluoroscopy, allows for intraoperative image acquisition after surgical exposure, reduces intraoperative registration time, reduces both surgeon and patient radiation exposure, and allows immediate computerized tomographic imaging in the operating room to verify screw position.

Esophageal injury is a rare but serious complication occurring after anterior cervical spine surgery. Pharyngoesophageal, or Zenker, diverticulum is an acquired outpouching of the pharyngeal musculature just proximal to a functional esophageal stricture, clinically manifesting as dysphagia, aspiration, and weight loss. We report a case in which a patient developed a pharyngoesophageal diverticulum, accompanied by retropharyngeal abscess, first identified 2 years after a 3-level anterior cervical fusion with allograft and anterior plating. The inferior portion of the cervical plate was dislodged anteriorly. In addition, the patient harbored pulmonary and mediastinal infection at the time of presentation. Despite incision and drainage of the abscess with repair of the diverticulum, the patient died in the early postoperative period. Prompt recognition and frequent follow-up, as well as patient education, may prevent this catastrophic complication.