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C5-C7颈椎前路椎体次全切除融合术后并发食管穿孔的罕见病例，经手术行食管修复及长节段颈椎融合治疗

An Unusual Case of Esophageal Perforation Following C5-C7 Anterior Cervical Corpectomy and Fusion Managed Surgically With Esophageal Repair and Long-Segment Cervical Fusion.

作者信息

Pisal Tushar, Gurnani Sagar, Chaudhari Ajinkya K

机构信息

Department of Orthopaedics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to Be University), Pune, IND.

Department of Orthopaedics, Sainath Hospital, Pune, IND.

出版信息

Cureus. 2024 Nov 7;16(11):e73256. doi: 10.7759/cureus.73256. eCollection 2024 Nov.

DOI:10.7759/cureus.73256
PMID:39651009
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11625174/
Abstract

Anterior cervical corpectomy and fusion (ACCF) is frequently the surgical management for myelopathy, radiculopathy, and cervical spine trauma. Although esophageal perforation is an uncommon complication, it remains a serious concern. This report details the case of a 50-year-old female who underwent a C6 corpectomy with C5-C7 ACCF due to degenerative pathology and subsequently developed an esophageal perforation that required revision surgery and surgical repair of the perforated esophagus. A comprehensive review for surgically managing esophageal perforation following cervical spine surgery is essential for intensivists to improve postoperative airway management strategies.

摘要

颈椎前路椎体次全切除融合术（ACCF）常用于治疗脊髓病、神经根病和颈椎创伤。尽管食管穿孔是一种罕见的并发症，但仍是一个严重问题。本报告详细介绍了一名50岁女性的病例，该患者因退行性病变接受了C6椎体次全切除及C5 - C7颈椎前路椎体次全切除融合术，随后发生食管穿孔，需要进行翻修手术及对穿孔食管进行手术修复。对颈椎手术后食管穿孔的手术管理进行全面综述，对于重症监护医生改进术后气道管理策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/912c69e24701/cureus-0016-00000073256-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/9d887127a028/cureus-0016-00000073256-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/d63407d4ecb5/cureus-0016-00000073256-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/7f5651f8e7f7/cureus-0016-00000073256-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/05bfeec29555/cureus-0016-00000073256-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/d63a4bcd22d4/cureus-0016-00000073256-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/52f6557301e3/cureus-0016-00000073256-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/912c69e24701/cureus-0016-00000073256-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/9d887127a028/cureus-0016-00000073256-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/d63407d4ecb5/cureus-0016-00000073256-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/7f5651f8e7f7/cureus-0016-00000073256-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/05bfeec29555/cureus-0016-00000073256-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/d63a4bcd22d4/cureus-0016-00000073256-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/52f6557301e3/cureus-0016-00000073256-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca4/11625174/912c69e24701/cureus-0016-00000073256-i07.jpg

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本文引用的文献

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Anterior cervical spine surgery-associated complications in a retrospective case-control study.一项回顾性病例对照研究中的颈椎前路手术相关并发症
J Spine Surg. 2017 Sep;3(3):444-459. doi: 10.21037/jss.2017.08.03.
2
Dysphagia Rates after Anterior Cervical Diskectomy and Fusion: A Systematic Review and Meta-Analysis.颈椎前路椎间盘切除融合术后吞咽困难发生率：一项系统评价与荟萃分析
Global Spine J. 2017 Feb;7(1):95-103. doi: 10.1055/s-0036-1583944. Epub 2017 Feb 1.
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Esophageal Perforation Following Anterior Cervical Spine Surgery: Case Report and Review of the Literature.
颈椎前路手术后食管穿孔：病例报告及文献复习
Global Spine J. 2017 Apr;7(1 Suppl):28S-36S. doi: 10.1177/2192568216687535. Epub 2017 Apr 1.
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Delayed Esophagus Perforation after Anterior Cervical Spine Surgery.颈椎前路手术后的迟发性食管穿孔
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Esophageal perforation after anterior cervical spine surgery: a systematic review of the literature.颈椎前路手术后食管穿孔：文献系统综述
J Neurosurg Spine. 2016 Sep;25(3):285-91. doi: 10.3171/2016.1.SPINE15898. Epub 2016 Apr 15.
6
Delayed presentation of pharyngeal erosion after anterior cervical discectomy and fusion.颈椎前路椎间盘切除融合术后咽后壁糜烂的延迟表现
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Esophageal perforation related to anterior cervical spinal surgery.与前颈椎脊柱手术相关的食管穿孔。
J Clin Neurosci. 2013 Oct;20(10):1402-5. doi: 10.1016/j.jocn.2012.11.020. Epub 2013 Jul 24.
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Dysphagia after anterior cervical discectomy and fusion: a prospective study comparing two anterior surgical approaches.颈椎前路椎间盘切除融合术后吞咽困难：两种前路手术入路的前瞻性研究。
Eur Spine J. 2013 May;22(5):1147-51. doi: 10.1007/s00586-012-2620-5. Epub 2013 Jan 1.
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Current management of esophageal perforation: 20 years experience.食管穿孔的当前管理：20年经验
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Esophageal perforation with a locking screw: a case report and review of the literature.食管穿孔伴锁定螺钉：一例病例报告及文献综述
Spine (Phila Pa 1976). 2007 Jul 1;32(15):E428-35. doi: 10.1097/BRS.0b013e318074d56c.