Complications of Spine Surgery: Esophageal Injury and Voice Complications

Abstract

Esophageal injuries, dysphagia, and dysphonia may arise as a result of direct trauma to nerves and tissues during anterior cervical spine surgery, indirectly during endoscopy or endotracheal tube placement, or postoperatively as a result of chronic irritation or erosion of tissues due to sharp or prominent instrumentation. Esophageal perforations are rare complications, but are potentially fatal. Once diagnosed, treatment involves wound débridement, immediate repair or reconstruction, and broad-spectrum antibiotic therapy to prevent life-threatening sequelae such as mediastinitis. Some degree of dysphagia and dysphonia is typical after anterior cervical spine surgery, but patients with symptoms that persist or are more significant after 6 weeks should undergo an otololaryngology consultation. Careful surgical technique and adherence to certain safety principles during endoscopic procedures and intubation can help minimize these complications.

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