• Ju-Hwi Kim, Seul-Kee Lee, Jong-Hwan Hong, Bong Ju Moon, and Jung-Kil Lee.
• Department of Neurosurgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea.
• World Neurosurg. 2019 May 1; 125: 87-92.

BackgroundA 26-year-old man presented with acute quadriparesis owing to a traffic accident. A computed tomography scan revealed a hangman fracture and locking of the left facet joint at C2-3. Magnetic resonance imaging showed a high signal change of the spinal cord on T2-weighted image and hemorrhage in the C2-3 level.Case DescriptionAn emergency closed reduction after anterior cervical diskectomy and fusion were performed for spinal stability and decompression of the dural sac. Five months postoperatively, C1-2-3 posterior wiring using an iliac bone graft with the Brook method was performed due to nonunion of C2-3. After using the posterior cervical approach, the patient began complaining about the difficulty in swallowing. A 5 × 2 × 1-cm-sized posterior pharyngeal wall mass was detected on an endoscopic examination. Despite conservative management, the retropharyngeal mass progressed and dysphagia worsened, so the retropharyngeal wall granulation mass was resected by a laryngologist. Despite removal of the granulation mass, dysphagia and throat discomfort persisted for about 2 years. The plate and screws were removed considering their possible correlation with the granulation tissue. One month after plate removal, the retropharyngeal granulation tissue resolved almost spontaneously. At the last follow-up, the radiologic examination showed well-fused C1-2-3 with good alignment. The patient had no residual neurologic deficits or dysphagia.ConclusionsRetropharyngeal granulation can occur as a late complication associated with plate fixation after anterior cervical diskectomy and fusion. Recurrent retropharyngeal wall granulation caused by plate irritation might only be resolved after plate and screw removal.Copyright © 2019 Elsevier Inc. All rights reserved.

35 keywords...

hide…