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Case Reports in Orthopedics
Volume 2015 (2015), Article ID 173687, 4 pages
http://dx.doi.org/10.1155/2015/173687
Case Report

Delayed Presentation of Pharyngeal Erosion after Anterior Cervical Discectomy and Fusion

1Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI 48109, USA
2Department of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA

Received 1 December 2014; Accepted 14 January 2015

Academic Editor: Ali F. Ozer

Copyright © 2015 Amit Nathani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Dysphagia after anterior cervical discectomy and fusion (ACDF) is common, with a prevalence ranging between 28% and 57% of cases. However, nearly all cases resolve spontaneously within 2 years, thus identifying patients who require more detailed or invasive work-up is a challenging task for clinicians. A review of literature reveals a paucity of case reports detailing work-up and successful management options. The authors performed a clinical and radiographic review of a case of a 47-year-old female who presented with persistent dysphagia 3 years following anterior cervical spine surgery and was found to have an erosive pharyngeal defect with exposed spinal hardware. The diagnosis was made with direct laryngoscopy and treatment consisted of plate removal and pharyngeal repair, followed by revision fusion with deformity correction. This case and the accompanying pertinent review of the literature highlight the importance of a thorough evaluation of dysphagia, especially in the mid- and late-term postoperative period following ACDF, when most cases of dysphagia should have been resolved. Correctly identifying the underlying etiology of dysphagia may lead to improved revision of ACDF outcomes. Unresolved dysphagia should be a red flag for surgeons as it may be the presentation of erosive esophageal/pharyngeal damage, a rare but serious complication following ACDF.