Successful Surgical Treatment of Anterior Fusion Cage Dislocation into the Cervical Esophagus

Abstract

Merab A. Kiladze, Temur Bolkvadze, Budu Shalamberidze, Malkhaz Kintsurashvili, Ioseb Dushashvili and Irakli Gogokhia

We report on a 50-year-old patient’s case, who underwent ventral and dorsal cervical fusion for polytrauma due to car accident. The patient suffered very rare complication of the surgery-cage dislocation into the cervical esophagus. He underwent multiple surgical interventions: ventral and dorsal cervical fusion, laminectomy, tracheostomy, epicystostomy, gastrostomy. The surgical treatment was divided into two stages. At the first stage, open cholecystectomy and gastrostomy correction were performed and at the second stage, extraction of the cage and closure of the esophageal wall defect were performed. To prevent failure of the sutures placed on the wound of the esophagus, the method of covering the suture line with a pedicled flap cut from the medial portion of the sternocleidomastoid muscle was used. The control X-Ray examination was performed at 6th p/o day, which reveals no extravasation and free passage of contrast to the stomach. The patient after almost a three-year break began peroral eating and was discharged the hospital at 10th p/o day. We consider, that the method of covering the suture line by pedicled flap from sternocleidomastoid muscle in cases of difficult suturing of defects of the cervical esophagus, is a good surgical option. Surgeons should be aware of the risk of cage dislocation of cervical fusion procedure.

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