{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T13:49:19Z","timestamp":1750772959829},"reference-count":36,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>The anterior approach to the cervical spine is safe and effective, but not without risks. The pharyngoesophageal perforation (PEP) is a rare but potentially life-threatening complication of this surgical route. A prompt diagnosis and adequate treatment are crucial for the prognosis; nevertheless, there is no unique consent about the best management.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>A 47-year-old woman was referred to our neurosurgical unit for clinical and neuroradiological signs of multilevel cervical spine spondylodiscitis, which was conservatively treated with long-term antibiotic therapy and cervical immobilization after computed tomography-guided biopsy. Nine months later, when the infection was resolved, the patient underwent C3\u2013C6 spinal fusion with anterior plate and screws through anterior approach to the cervical spine for degenerative vertebral changes causing severe myelopathy, and C5\u2013 C6 retrolisthesis with instability. Five days after surgical procedure, the patient developed a pharyngoesophageal-cutaneous fistula, detected through wound drainage, and confirmed by swallowing contrast study, without systemic signs of infection. The PEP was conservatively treated, with antibiotic therapy and parenteral nutrition, and it was monitored through seriate swallowing contrast and magnetic resonance studies up to the complete resolution.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>The PEP is a potentially fatal complication of the anterior cervical spine surgery. We suggest an accurate intraoperative control of the pharyngoesophageal\u2019s tract integrity at the end of the surgical procedure and a longtime follow-up, because the risk of occurrence is up to several years after surgery.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_114_2023","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T06:36:03Z","timestamp":1679639763000},"page":"102","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cervical epidural abscess complicated by a pharyngoesophageal perforation after anterior cervical spine surgery for subaxial spondylodiscitis"],"prefix":"10.25259","volume":"14","author":[{"given":"Giuseppe","family":"Mariniello","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, \u201cFederico II\u201d University, Naples, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Corvino","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, \u201cFederico II\u201d University, Naples, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Corazzelli","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, \u201cFederico II\u201d University, Naples, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Maiuri","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, \u201cFederico II\u201d University, Naples, 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