Na Dohyun, Eom Ki Seong
Department of Neurosurgery, Wonkwang University School of Medicine, Iksan, Korea.
Korean J Neurotrauma. 2024 Sep 19;20(3):203-208. doi: 10.13004/kjnt.2024.20.e27. eCollection 2024 Sep.
Although anterior cervical discectomy and fusion (ACDF) is one of the most common surgical procedures performed for the treatment of cervical disease, it is associated with a variety of postoperative complications. Esophageal perforation is a rare but very serious post-ACDF complication, and cases in which screws extrude through the mouth are even rarer. Herein, we present the case of a 61-year-old woman who visited our emergency center with oral extrusion of a screw 6 months after undergoing ACDF. Although diagnostic imaging did not confirm esophageal perforation, the oral extrusion of the screw was clear evidence of the complication. To the best of our knowledge, this is the first reported case of oral screw extrusion without confirmed esophageal injury. This case suggests that screw migration and esophageal perforation can occur depending on the patient's underlying condition, and if the symptoms are mild, conservative treatment alone may be sufficient to treat the perforation.
尽管颈椎前路椎间盘切除融合术（ACDF）是治疗颈椎疾病最常见的外科手术之一，但它会引发多种术后并发症。食管穿孔是ACDF术后一种罕见但非常严重的并发症，而螺钉经口腔穿出的病例更为罕见。在此，我们报告一例61岁女性患者，她在接受ACDF术后6个月因螺钉经口腔穿出而前来我院急诊中心就诊。尽管诊断性影像学检查未证实食管穿孔，但螺钉经口腔穿出是该并发症的确切证据。据我们所知，这是首例报道的未证实食管损伤的螺钉经口腔穿出病例。该病例提示，螺钉移位和食管穿孔可能因患者的基础病情而异，如果症状较轻，仅采取保守治疗可能足以治疗穿孔。
