Esophageal perforation more than one year following anterior cervical spinal surgery

We illustrate a rare case of a delayed esophageal perforation occurring ˃1 year after anterior cervical spinal surgery for trauma, without evidence of instrumentation failure. The patient presented with dysphagia, headache, and posterior neck pain. A swallow study confirmed posterior esophageal defect and surgical repair was performed using pectoralis flap. Literature review revealed limited cases of esophageal perforation beyond one year later following anterior cervical spinal surgery related to trauma without hardware failure. Most delayed esophageal injuries occur within 2 years and are related to instrumentation failure; cases without instrumentation failure are not commonly presented. Despite their rarity, clinicians should consider esophageal perforation in patients with a prior history of anterior cervical spinal surgery presenting symptoms of esophageal dysfunction. This case report emphasizes prompt recognition and intervention are essential for better outcomes; recommending multidisciplinary approach with neurological surgery and otolaryngology to perform diagnostics and necessary interventions.