Management of Cervical Esophageal Injury After Spinal Surgery

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Presentation transcript:

Management of Cervical Esophageal Injury After Spinal Surgery Natasha Rueth, MD, Darcy Shaw, MD, Shawn Groth, MD, Sarah Stranberg, MA, CCC-SLP, Jonathan D'Cunha, MD, PhD, Jonathan Sembrano, MD, Michael Maddaus, MD, Rafael Andrade, MD The Annals of Thoracic Surgery Volume 90, Issue 4, Pages 1128-1133 (October 2010) DOI: 10.1016/j.athoracsur.2010.06.045 Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Intraoperative image of patient with osteomyelitis and vertebral body destruction. Anterior cervical cage is protruding through destroyed vertebral body. The anterior plate has been removed. (B) Intraoperative image of a low cervical esophageal perforation. The esophageal edges have been debrided, and the esophagoscope is visible in the defect prior to primary closure. The Annals of Thoracic Surgery 2010 90, 1128-1133DOI: (10.1016/j.athoracsur.2010.06.045) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Computed tomographic scan demonstrating esophageal perforation. The white arrow points to the cervical hardware, the black arrow shows air in the soft tissues. The Annals of Thoracic Surgery 2010 90, 1128-1133DOI: (10.1016/j.athoracsur.2010.06.045) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Algorithm summarizing standardized management approach. (ACS = anterior cervical spine.) The Annals of Thoracic Surgery 2010 90, 1128-1133DOI: (10.1016/j.athoracsur.2010.06.045) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions