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ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
Volume 11 - 2024 |
doi: 10.3389/fmed.2024.1484712
Bone resorption as a marker for delayed esophageal perforation post anterior cervical spine surgery: a retrospective analysis and call for increased vigilance
Provisionally accepted- Zhejiang Taizhou Hospital, Taizhou, China
Purpose: Delayed esophageal perforation following anterior cervical spine surgery (ACSS) is a rare but serious complication. This study is to investigate the clinical characteristics, diagnostic approaches, and treatment outcomes of delayed esophageal perforation following ACSS, with a focus on the role of bone resorption around internal fixations as a potential diagnostic indicator.We retrospectively analyzed patients diagnosed with delayed esophageal perforation after ACSS from January 2010 to December 2023 and described their clinical characteristics, diagnostic approaches, and treatment outcomes. Through the analysis of the differences in the radiomics of patients, we identified the possible clinical signs of esophageal perforation and shared our experience in treating esophageal perforation.: A total of five patients met our criteria. All five patients exhibited bone resorption around their internal fixations on radiography. Although bone resorption typically suggests local infection, none of the patients showed clear signs of neck skin infection, leading us to suspect esophageal perforation as the underlying cause. Further diagnostic procedures including CT, MRI, esophagography, and endoscopy were crucial for confirming the diagnosis of delayed esophageal perforation and assessing its severity. All patients underwent surgical intervention involving implant removal and esophageal repair using a sternocleidomastoid muscle flap transfer. All patients recovered and were discharged after treatment, with no recurrence of symptoms during follow-up. Conclusions: Delayed esophageal perforation should be considered in patients with neck pain or nonspecific symptoms after ACSS, especially with bone resorption around internal fixations. Clinicians should maintain high vigilance and use multimodal imaging and endoscopy for timely diagnosis. Our study indicates a significant link between bone resorption and delayed esophageal perforation despite the limited number of cases. Highlighting this association aims to raise awareness and encourage further research. Larger studies are needed to validate our findings, improve clinical guidelines, and ultimately enhance patient outcomes in orthopedics.
Keywords: Bone Resorption, Delayed esophageal perforation, Anterior cervical spine surgery, esophageal repair, complication
Received: 23 Aug 2024; Accepted: 18 Oct 2024.
Copyright: © 2024 Luo, Wang, Mi, Yang, Pan, Feng and Hong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhangfu Wang, Zhejiang Taizhou Hospital, Taizhou, China
Shuang Mi, Zhejiang Taizhou Hospital, Taizhou, China
Guangyong Yang, Zhejiang Taizhou Hospital, Taizhou, China
Wenjun Pan, Zhejiang Taizhou Hospital, Taizhou, China
Xingbing Feng, Zhejiang Taizhou Hospital, Taizhou, China
Zhenghua Hong, Zhejiang Taizhou Hospital, Taizhou, China
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