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Christopher I. Shaffrey 《European spine journal》2010,19(11):1812-1814
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Charles A. Sansur Stephen Early James Reibel Vincent Arlet 《European spine journal》2009,18(5):586-592
Pharyngocutaneous fistulae are rare complications of anterior spine surgery occurring in less than 0.1% of all anterior surgery
cases. We report a case of a 19 year old female who sustained a C6 burst fracture with complete quadriplegia. She was treated
urgently with a C6 corpectomy with anterior cage and plating followed by posterior cervical stabilization at another institution.
Post operatively she developed a pharyngocutaneous fistula that failed to heal despite several attempts of closure and esophageal
exclusion with a Jpeg tube. The patient was eventually successfully treated with a three-stage procedure consisting of firstly
a posterior approach to reinforce the posterior stabilization of the cervical spine that was felt to be inadequate, secondly
an anterior approach with removal of all the anterior instrumentation followed by iliac crest bone graft and thirdly a superior
based sternocleidomastoid flap that was interposed between the esophagus and the anterior cervical spine. The patient's fistula
healed successfully. However, yet asymptomatic, the anterior iliac crest bone graft resorbed almost completely at 16 months
follow up. In light of this complication, we discuss the surgical options for the treatment of pharyngocutaneous fistulae
and the closure of this fistula using a superiorly based sternocleidomastoid muscle flap. 相似文献