Newhouse K E, Lindsey R W, Clark C R, Lieponis J, Murphy M J
Department of Orthopaedic Surgery, University of Iowa, Iowa City.
Spine (Phila Pa 1976). 1989 Oct;14(10):1051-3. doi: 10.1097/00007632-198910000-00004.
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 reexploration 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 hospitalization. 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.
作者对颈椎研究协会进行了调查，以汇编一系列颈椎前路手术后发生的食管穿孔病例。共收集到22例病例。6例发生在手术时，6例发生在术后，10例发生在术后数周或数月后。8例手术是由于骨折。25%的术后病例与植入物有关。诊断大多通过再次探查时的直视或食管造影得以证实。治疗通常包括引流、修复和静脉使用抗生素；2例仅通过肠内营养和抗生素治疗成功。有1例死亡，所有患者均需长期住院。颈椎骨折和植入物的使用可能与该并发症有关。临床怀疑和食管造影是重要的诊断工具。推荐的治疗方法是引流和静脉使用抗生素。
