Recurrent dysphagia after lower posterior cervical fusion

Abstract

Background: Although dysphagia following posterior craniocervical fixation is well known, the incidence after mid-lower posterior cervical fixation is not well described. Here, we presented a case of recurrent dysphagia in a 72-year-old male following C3-T3 posterior cervical fixation and discussed its etiology. Case Description: A 72-year-old male sustained a cervical fracture in a fall; he was neurologically intact. The cervical/thoracic MR and CT studies documented ankylosing spondylitic changes in the cervicothoracic spine, a C5/6 disc herniation, and a C7 vertebral fracture. He underwent posterior cervical C3 to T3 fusion without decompression. For the 1st postoperative day, he complained of dysphagia without hoarseness, and fiberoptic endoscopy revealed poor esophageal mobility. For the next 6 postoperative years, he continued to require repeated attempts at the dilation of the esophageal entrance but remained reliant on a feeding tube. Conclusion: Posterior cervical fixation restricts cervical motion and may restrict expansion of the esophageal duct leading to permanent postoperative dysphagia requiring continued feeding tube utilization.