Recurrent dysphagia after lower posterior cervical fusion

Area of Science:

• Spine surgery outcomes
• Gastrointestinal complications
• Cervical spine biomechanics

Background:

• Dysphagia is a known complication of posterior craniocervical fixation.
• The incidence of dysphagia after mid-lower posterior cervical fixation is less understood.
• This study examines a case of recurrent dysphagia after C3-T3 posterior cervical fixation.

Observation:

• A 72-year-old male with ankylosing spondylitis, C5/6 disc herniation, and C7 fracture underwent C3-T3 posterior cervical fusion.
• Postoperatively, the patient developed dysphagia and poor esophageal mobility.
• Despite interventions, the patient required a feeding tube for six years.

Findings:

• Posterior cervical fixation significantly restricts cervical motion.
• This restriction can impede esophageal expansion, leading to dysphagia.
• The patient experienced permanent postoperative dysphagia necessitating long-term feeding tube use.

Implications:

• Surgeons should consider the risk of dysphagia in patients undergoing posterior cervical fixation, especially extensive fusions.
• Assessment of esophageal mobility may be crucial in patients with postoperative swallowing difficulties.
• Understanding the biomechanical impact of cervical fixation on esophageal function is vital for improving patient outcomes.