Erosion of Anterior Cervical Plate into Pharynx with Pharyngotracheal Fistula

Kuo, Yuo-Chen; Levine, Marc S.

doi:10.1007/s00455-009-9271-7

Cited by 17 publications

(18 citation statements)

References 18 publications

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“…Chronic contact between the pharyngoesophageal junction and adjacent cervical plate may cause pressure necrosis and a foreign body reaction with subsequent erosion of the plate into the lumen. 6 In this case, the esophageal stent likely increased the pressure between the cervical plate and the mucosal wall, resulting in pressure necrosis and a foreign-body reaction that eroded the intervening tissue between the esophageal lumen and the cervical plate. Our major concern was the prospect of the patient's developing osteomyelitis and colonization of the disc-bone interface.…”

Section: Discussionmentioning

confidence: 97%

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Esophageal stent–induced fistulization to an anterior cervical plate

Guarner-Argente¹,

Chandrasekhara²,

Levine³

et al. 2011

Gastrointestinal Endoscopy

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Section: Discussionmentioning

confidence: 97%

“…A much less common but serious complication is erosion or migration of a cervical plate into the lumen of the pharynx or esophagus. [6][7][8][9] The mechanism for erosion of an anterior cervical plate is not well-understood. The relatively sharp edge of a screw or plate abutting the pharynx or esophagus has been implicated.…”

Section: Discussionmentioning

confidence: 99%

Esophageal stent–induced fistulization to an anterior cervical plate

Guarner-Argente¹,

Chandrasekhara²,

Levine³

et al. 2011

Gastrointestinal Endoscopy

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“…[67] In the trauma setting, vertebral body fracture may require corpectomy in which ACDF is typically performed in conjunction with posterior instrumentation. [26]…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, chronic compression of the esophagus against the anterior cervical plate during swallowing can result in pressure necrosis and eventually perforation and fistula formation. [2457]…”

Section: Discussionmentioning

confidence: 99%

Esophageal perforation following cervical spine surgery: A review with considerations in airway management

Amhaz

Kuo

Vaidya

et al. 2013

Int J Crit Illn Inj Sci

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Anterior cervical discectomy and fusion (ACDF) is a commonly performed surgery for the treatment of spondylosis, radiculopathy, myelopathy, and trauma to the cervical spine. Esophageal perforation is a rare yet serious complication following ACDF with an incidence of 0.02 to 1.52%. We describe a case of a 24-year-old man who underwent ACDF and corpectomy following a motor vehicle accident who subsequently developed delayed onset esophageal perforation requiring surgical intervention. We believe that the detailed review of the surgical management of esophageal perforation following cervical spine surgery will provide a deeper understanding for the Intensivist in regards to postoperative airway management in these types of patients. Careful extubation over a soft flexible exchange catheter should take place to help reduce the risk of perforation in the event reintubation is required.

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“…Examples of such implant-associated complications include screw loosening, screw breakage, and plate breakage, screw pullout with or without migration into gastrointestinal tract (8, 13,16,24,27,37). Rarely, erosion of anterior cervical plate into pharynx with pharyngotracheal fistula (22) or pharyngocutaneous fistula may occur (31). Although rigid plate design with screws rigidly locked to the plate is thought to provide a better fixation for the treated spinal segment than a dynamic design in which the screws may slide when the graft is settling (37), Pitzen et al (28) recently found that dynamic cervical plate designs provide less implant complications, less implant failure-related revision surgery and faster speed of fusion compared with rigid cervical plates.…”

Section: A B Azab W Et Al: Anterior Cervical Diskectomy With Zero-prmentioning

confidence: 99%

Outcome evaluation of a zero-profile implant for anterior cervical diskectomy with fusion

Azab¹,

Abdel-Razek²,

Ali³

et al. 2012

Turkish Neurosurgery

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AIm: Supplementing anterior cervical diskectomy and fusion (ACDF) with plates enhances stabilization, increases fusion and reduces failure rates. Zero-P implant for stand-alone anterior interbody fusion procedures of the cervical spine was recently developed to avoid complications associated with anterior cervical plates. We evaluate the outcome of its use in our patients undergoing ACDF. mATeRIAL and meTHods: 84 patients were selected to undergo ACDF with Zero-P implant of whom 75 (52 male and 23 female) were followed up for 12 to 16 months (mean 14.2 months) with a total of 94 operated levels (54 single, 21 double level). Patients underwent pre-and postoperative clinical evaluation with full neurological examination, visual analogue scale (VAS), Neck Pain and Disability Scale (NPAD) and Bazaz-Yoo dysphagia index for postoperative dysphagia. Postoperative plain X-ray evaluation of fusion and implant-associated complications was done.ResuLTs: All patients had significant reduction in arm and neck pain and NPAD maintained over 12 months, no implant-associated complications during follow-up, and radiological fusion by 3 months. None had dysphagia after 3 months postoperatively. CoNCLusIoN:The Zero-P implant is a valid alternative to anterior cervical plating after ACDF with a very low incidence of postoperative dysphagia and no implant-related complications.KeywoRds: Anterior, Cervical, Diskectomy, Zero-profile, Plate, Dysphagia ÖZ AmAÇ: Anterior servikal diskektomi ve füzyonu (ACDF) plakalarla desteklemek stabilizasyonu güçlendirir, füzyonu arttırır ve başarısızlık oranını azaltır. Anterior servikal plakalarla ilişkili komplikasyonlardan kaçınmak üzere yakın zamanda servikal omurganın tek başına anterior interbody füzyon işlemleri için Zero-P implantı geliştirilmiştir. ACDF yapılan hastalarımızda bu implantın kullanılmasının sonuçlarını değerlendirdik. BuLGuLAR: Tüm hastalarda 12 ay boyunca devam edecek şekilde kol ve boyun ağrısı ve NPAD bakımından önemli azalma oldu, takip boyunca implantla ilişkili komplikasyon görülmedi ve 3 ay içinde radyolojik füzyon gerçekleşti. Ameliyattan 3 ay sonra hiçbirinde disfaji yoktu.soNuÇ: Zero-P implantı ACDF sonrasında servikal plakalama için geçerli bir alternatiftir ve postoperatif disfaji insidansı çok düşük olup implantla ilişkili bir komplikasyon görülmemiştir.

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Erosion of Anterior Cervical Plate into Pharynx with Pharyngotracheal Fistula

Cited by 17 publications

References 18 publications

Esophageal stent–induced fistulization to an anterior cervical plate

Esophageal stent–induced fistulization to an anterior cervical plate

Esophageal perforation following cervical spine surgery: A review with considerations in airway management

Outcome evaluation of a zero-profile implant for anterior cervical diskectomy with fusion

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