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Esophageal Perforation Following Anterior Cervical Spine Surgery

NEWHOUSE, KENNETH E., MD*; LINDSEY, RONALD W., MD; CLARK, CHARLES R., MD; LIEPONIS, JONAS, MD; MURPHY, MICHAEL J., MD

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The authors surveyed the Cervical Spine Research Society to compile a series of esophageal perforations following anterior cervical spine surgery. Twenty-two cases were assembled. Six occurred at the time of surgery, 6 in the postoperative period, and 10 weeks to months later. Eight surgeries were because of fracture. Hardware was implicated In 25% of cases occurring after surgery. Diagnosis was confirmed most often by direct vision at reexploratlon or esophography. Treatment usually consisted of drainage, repair, and parenteral antibiotics; 2 cases were successfully treated by enteral feeding and antibiotics alone. There was one fatality, and all patients required prolonged hospitallzatlon. Cervical fracture and the use of hardware may be associated with this complication. Clinical suspicion and esophography are important diagnostic tools. Drainage and parenteral antibiotics are recommended treatment.

*From the Department of Orthopaedic Surgery at The University of Iowa, Iowa City, Iowa

†From the Department of Baylor College of Medicine, Waco, Texas

‡From the Department of Yale University, New Haven, Connecticut

© Lippincott-Raven Publishers.