• Tajrian Amin, Henry Lin, William C H Parr, Patrick Lim, and Ralph J Mobbs.
• NeuroSpine Surgery Research Group, Sydney, Australia; Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia.
• World Neurosurg. 2021 Jul 1; 151: 29-38.

BackgroundEsophageal fistulae are rare, though serious, complications of anterior cervical surgery. Hardware-related issues are important etiologic factors. Patient-specific implants (PSIs) have increasingly been adapted to spinal surgery and offer a range of benefits. Zero-profile implants are a recent development primarily aimed at combating postoperative dysphagia. We report the first use of a 3-dimensional (3D)-printed zero-profile PSI in managing implant failure with migration and a secondary esophageal fistula.MethodsA 68-year-old female had a prior C5-7 corpectomy with cage and plate fixation, as well as posterior C3-T1 lateral mass fixation, complicated by anterior plate displacement, resulting in pseudoarthrosis and an esophageal fistula. A 3D-printed zero-profile PSI was designed and implanted as part of a revision procedure to assist in recovery, prevent recurrence, and facilitate bony fusion.ResultsOptimal implant placement was achieved on the basis of preoperative virtual surgical planning. By 1 month postoperatively the patient had significantly improved, with evidence of esophageal fistula resolution and radiographic evidence of optimal implant placement.ConclusionsZero-profile 3D-printed PSIs may combat common and serious complications of anterior cervical surgery including postoperative dysphagia and esophageal fistulae. Further research is required to validate their widespread use for either cervical corpectomy or diskectomy and interbody fusion.Copyright © 2021 Elsevier Inc. All rights reserved.

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