• Raj Swaroop Lavadi, Avi A Gajjar, Galal A Elsayed, Rupen R Desai, Rida Mitha, Sidharth V Puram, and Nitin Agarwal.
• Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
• World Neurosurg. 2023 Jul 1; 175: 9810198-101.

BackgroundAnterior cervical discectomy and fusion (ACDF) is a commonly performed procedure for degenerative cervical spine disease. Rare complications of ACDF surgery include hardware failure, in the form of screw loosening and migration, or rod breakage. We present a case in which we removed a migrated screw lodged in the esophagus from a patient with a failed anterior cervical fusion.ObjectiveTo present a surgical technique and considerations to remove a migrated screw.MethodsThe previous ACDF incision was reopened and exposure was gained under the guidance of a head and neck surgeon. Longus coli were mobilized off the spine bilaterally with electrocautery. After dissection, the screw was found lodged in the longitudinal muscle of the esophageal wall and excised with the use of a 15-blade. The integrity of the esophageal mucosa and submucosa was maintained and subsequently checked with rigid esophagoscopy. Fluoroscopy was used to confirm that all hardware was removed, with the exception of the anterior cages.ResultsThe dislodged screw, which was embedded in the esophagus, was successfully removed.ConclusionsFailure of an ACDF carries a risk of screw migration, which may be asymptomatic even if the screw is lodged in the esophagus. Additional considerations are required with potential violations of the adjacent viscera.Copyright © 2023 Elsevier Inc. All rights reserved.

22 keywords...

hide…