Abstract
An esophageal injury after an anterior cervical discectomy and fusion with plating is a well known but a fatal complication. If the diagnosis is delayed, inflammation can spread out into the neighboring main organs resulting in a very poor prognosis despite vigorous treatment. W e report a case of esophageal fistula formation as a result of infected metal loosening after an anterior cervical discectomy and fusion with plating, which was treated successfully with a satisfactory clinical outcome.
Figures and Tables
Fig. 1
Radiographs immediately after the index operation at a local clinic shows a normal sagittal alignment with cages and plate in the correct position.
![jkoa-42-404-g001](/upload/SynapseData/ArticleImage/0043jkoa/jkoa-42-404-g001.jpg)
Fig. 2
Radiographs 8 months after the index operation; back-out of screws, one screw lost after the index surgery with suspicious infectious loosening. The white arrow indicates gas in the pouch at the midportion of the plate.
![jkoa-42-404-g002](/upload/SynapseData/ArticleImage/0043jkoa/jkoa-42-404-g002.jpg)
Fig. 3
Follow-up radiograph of plain film at the secondary visit. Radiographs 18 months after the index operation; back-out of screws, another screw lost after the index surgery and progressive infectious loosening. The white arrow indicates gas in the pouch at the lower part of the plate.
![jkoa-42-404-g003](/upload/SynapseData/ArticleImage/0043jkoa/jkoa-42-404-g003.jpg)
Fig. 4
Initial esophagogram taken 8 days after revision surgery. An approximately 6 mm sized esophageal fistula in esophagopharyngeal junction and an approximately 7 cm sized barium collection in the left sided paraesophageal region.
![jkoa-42-404-g004](/upload/SynapseData/ArticleImage/0043jkoa/jkoa-42-404-g004.jpg)
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