PMID- 33887971
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2192-5682 (Print)
IS  - 2192-5690 (Electronic)
IS  - 2192-5682 (Linking)
VI  - 12
IP  - 4
DP  - 2022 May
TI  - Pharyngo-Esophageal Perforation Following Anterior Cervical Spine Surgery: A 
      Single Center Experience and a Systematic Review of the Literature.
PG  - 719-731
LID - 10.1177/21925682211005737 [doi]
AB  - STUDY DESIGN: Case series and systematic review of the Literature. OBJECTIVES: 
      Pharyngo-esophageal perforation (PEP) is a rare, life-threatening complication of 
      anterior cervical spine surgery (ACSS). Best management of these patients remains 
      poorly defined. The aim of this study is to present our experience with this 
      entity and to perform a systematic Literature review to better clarify the 
      appropriate treatment of these patients. METHODS: Patients referred to our center 
      for PEP following ACSS (January 2002-December 2018) were identified from our 
      database. Moreover, an extensive review of the English Literature was conducted 
      according to the 2009 PRISMA guidelines. RESULTS: Twelve patients were referred 
      to our Institution for PEP following ACSS. Indications for ACSS were trauma (n = 
      10), vertebral metastases (n = 1) and disc herniation (n = 1). All patients 
      underwent hardware placement at the time of ACSS. There were 6 early and 6 
      delayed PEP. Surgical treatment was performed in 11 patients with total or 
      partial removal of spine fixation devices, autologous bone graft insertion or 
      plate/cage replacement, anatomical suture of the fistula and suture line 
      reinforcement with myoplasty. Complete resolution of PEP was observed in 6 
      patients. Five patients experienced PEP persistence, requiring further surgical 
      management in 2 cases. At a median follow-up of 18.8 months, all patients 
      exhibited permanent resolution of the perforation. CONCLUSIONS: PEP following 
      ACSS is a rare but dreadful complication. Partial or total removal of the 
      fixation devices, direct suture of the esophageal defect and coverage with tissue 
      flaps seems to be an effective surgical approach in these patients.
FAU - Moletta, Lucia
AU  - Moletta L
AD  - Department of Surgical, Oncological and Gastroenterological Sciences, University 
      of Padova, Clinica Chirurgica 3 degrees , Via Giustiniani 2, Padova, Italy.
FAU - Pierobon, Elisa Sefora
AU  - Pierobon ES
AD  - Department of Surgical, Oncological and Gastroenterological Sciences, University 
      of Padova, Clinica Chirurgica 3 degrees , Via Giustiniani 2, Padova, Italy.
FAU - Salvador, Renato
AU  - Salvador R
AUID- ORCID: 0000-0002-3281-0361
AD  - Department of Surgical, Oncological and Gastroenterological Sciences, University 
      of Padova, Clinica Chirurgica 3 degrees , Via Giustiniani 2, Padova, Italy.
FAU - Volpin, Francesco
AU  - Volpin F
AD  - Department of Neurosciences, University Hospital of Padova, Unit of Neurosurgery, 
      Via Giustiniani 2, Padova, Italy.
FAU - Finocchiaro, Francesco Massimiliano
AU  - Finocchiaro FM
AD  - Department of Surgery and Dentistry, University Hospital of Verona, Unit of 
      Orthopedic A, Piazzale Aristide Stefani, 1, Verona, Italy.
FAU - Capovilla, Giovanni
AU  - Capovilla G
AD  - Department of Surgical, Oncological and Gastroenterological Sciences, University 
      of Padova, Clinica Chirurgica 3 degrees , Via Giustiniani 2, Padova, Italy.
FAU - Piangerelli, Alfredo
AU  - Piangerelli A
AD  - Department of Surgical, Oncological and Gastroenterological Sciences, University 
      of Padova, Clinica Chirurgica 3 degrees , Via Giustiniani 2, Padova, Italy.
FAU - Ciccioli, Eleonora
AU  - Ciccioli E
AD  - Department of Surgical, Oncological and Gastroenterological Sciences, University 
      of Padova, Clinica Chirurgica 3 degrees , Via Giustiniani 2, Padova, Italy.
FAU - Zanchettin, Gianpietro
AU  - Zanchettin G
AD  - Department of Surgical, Oncological and Gastroenterological Sciences, University 
      of Padova, Clinica Chirurgica 3 degrees , Via Giustiniani 2, Padova, Italy.
FAU - Costantini, Mario
AU  - Costantini M
AD  - Department of Surgical, Oncological and Gastroenterological Sciences, University 
      of Padova, Clinica Chirurgica 3 degrees , Via Giustiniani 2, Padova, Italy.
FAU - Merigliano, Stefano
AU  - Merigliano S
AD  - Department of Surgical, Oncological and Gastroenterological Sciences, University 
      of Padova, Clinica Chirurgica 3 degrees , Via Giustiniani 2, Padova, Italy.
FAU - Valmasoni, Michele
AU  - Valmasoni M
AD  - Department of Surgical, Oncological and Gastroenterological Sciences, University 
      of Padova, Clinica Chirurgica 3 degrees , Via Giustiniani 2, Padova, Italy.
LA  - eng
PT  - Journal Article
DEP - 20210423
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
PMC - PMC9109565
OTO - NOTNLM
OT  - anterior cervical spine
OT  - cervical spine
OT  - esophageal injury
OT  - esophageal perforation
OT  - fusion
OT  - surgical flap
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2021/04/24 06:00
MHDA- 2021/04/24 06:01
PMCR- 2021/04/23
CRDT- 2021/04/23 05:25
PHST- 2021/04/24 06:00 [pubmed]
PHST- 2021/04/24 06:01 [medline]
PHST- 2021/04/23 05:25 [entrez]
PHST- 2021/04/23 00:00 [pmc-release]
AID - 10.1177_21925682211005737 [pii]
AID - 10.1177/21925682211005737 [doi]
PST - ppublish
SO  - Global Spine J. 2022 May;12(4):719-731. doi: 10.1177/21925682211005737. Epub 2021 
      Apr 23.