Lethal Necrotising Mediastinitis: A Rare but Critical Complication Post-Cervical Disc Arthroplasty
Sažetak
Cervical disc arthroplasty is one of the common procedures for treating cervical degenerative disc disease. Anterior cervical disk arthroplasty is associated with a minimal complication rate, with documented infection rates ranging from 0.07 % to 1.6 %. This article reports on a lethal case of infection following cervical disc arthroplasty. A 42-year-old female presented with dysphagia and a sensation of choking just four weeks following cervical disc arthroplasty. Radiological examination showed soft tissue swelling and extensive subcutaneous emphysema, but no implant displacement, loosening, or subsidence was found. The patient underwent debridement surgery promptly; however, her condition deteriorated, ultimately leading to her demise—postoperative infections following cervical disc arthroplasty frequently present with ambiguous symptoms. The onset of these infections can range from several months to years. This article conveys the importance of recognising the signs of infection to facilitate early treatment for patients experiencing post-cervical disc arthroplasty infections.
Reference
Laratta JL, Shillingford JN, Saifi C, Riew KD. Cervical disc arthroplasty: a comprehensive review of single-level, multilevel, and hybrid procedures. Glob Spine J. 2018;8(1):78–83. doi: 10.1177/2192568217701095.
Latka D, Kozlowska K, Miekisiak G, Latka K, Chowaniec J, Olbrycht T, et al. Safety and efficacy of cervical disc arthroplasty in preventing the adjacent segment disease: A meta-analysis of mid- to long-term outcomes in prospective, randomized, controlled multicenter studies. Ther Clin Risk Manag. 2019;15:531–9. doi: 10.2147/TCRM.S196349.
Ghobrial GM, Harrop JS, Sasso RC, Tannoury CA, Tannoury T, Smith ZA, et al. Anterior cervical infection: Presentation and incidence of an uncommon postoperative complication. Glob Spine J. 2017;7(1_suppl):12S-16S. doi: 10.1177/2192568216687546.
Kumar A, Parshad R, Suhani S, Bhattacharjee HK, Pirabu S, Goyal A. Descending necrotizing mediastinitis: a surgical challenge managed using subxiphoid VATS. ACS Case Rev Surg. 2022;3(6):6-10.
Tasiou A, Giannis T, Brotis AG, Siasios I, Georgiadis I, Gatos H, et al. Anterior cervical spine surgery-associated complications in a retrospective case-control study. J Spine Surg. 2017;3(3):444–59. doi: 10.21037/jss.2017.08.03.
Hur JW, Lee J-B, Kim J-H, Kim S-H, Cho T-H, Suh J-K, et al. Unusual fatal infections after anterior cervical spine surgeries. Korean J Spine. 2012;9(3):304. doi: 10.14245/kjs.2012.9.3.304.
Rosselló A, Sanmillán JL, López-Obarrio L, Pelegrín I, Gabarrós A, Godino O. Delayed surgical site infection 2 years after cervical disk arthroplasty. Case report and literature review. Neurocirugia 2019;30(2):81–6. doi: 10.1016/j.neucir.2018.02.004.
Faoury M, Shepherd B, Dare CJ, Sipaul F. Late infection six years post cervical arthroplasty detected following referral to a 2 week-wait head and neck cancer clinic: a case report. Int J Otorhinolaryngol Head Neck Surg 2019;5(2):486. doi: 10.18203/issn.2454-5929.ijohns20190484.
Shah JK, Romanelli F, Yang J, Rao N, Gerling MC. Esophagopharyngeal perforation and prevertebral abscess after anterior cervical discectomy and fusion: A case report. J Spine Surg. 2021;7(2):225–32. doi: 10.21037/jss-20-646.
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