Language
English
Publication Date
4-14-2025
Journal
Journal of Neurosurgery: Case Lessons
DOI
10.3171/CASE24720
PMID
40228407
PMCID
PMC12001055
PubMedCentral® Posted Date
4-14-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Background: Esophageal perforation is a rare but deadly complication of cervical spine fractures. Early identification can be difficult but is imperative for proper treatment and prevention of life-threatening infection. Once diagnosed, surgical drainage and broad-spectrum antibiotics can yield positive outcomes. The authors present a successfully managed case of cervical spine fracture with associated esophageal perforation and necrotizing fasciitis as well as an extensive literature review.
Observations: An 87-year-old male with a previous cervical laminectomy presented to the emergency department with shortness of breath after a ground-level fall. Initial CT imaging of the cervical spine was noted to have no abnormalities at the time, and the patient was sent home. Eight days later, he presented again with neck pain, spasm, overt hyperextension injury, and fracture of the C7 vertebra, which was seen on CT. Initial surgical fixation was aborted due to the discovery of necrotizing fasciitis resulting from esophageal perforation. After surgical repair, debridement, and antibiotics, the fracture was stabilized via C2-T3 posterior segmental instrumented fusion. Following a complex hospital course, the patient was ultimately discharged following inpatient rehabilitation at his neurological baseline.
Lessons: Esophageal perforation and necrotizing fasciitis from cervical spine injuries can be deadly if not diagnosed and managed early. A high level of suspicion should be maintained with disruption of the anterior column of the cervical spine. A combination of surgical and medical management can yield successful treatment.https://thejns.org/doi/10.3171/CASE24720
Keywords
cervical, infection, spinal cord injury, spine, trauma, esophageal perforation, necrotizing fasciitis
Published Open-Access
yes
Recommended Citation
Kavoussi, Arman; Ricciardelli, Ashley; Flores, Alex; et al., "Diagnosis and Management of Esophageal Perforation With Necrotizing Fasciitis in Traumatic Cervical Spine Injuries: Illustrative Case" (2025). Faculty and Staff Publications. 5349.
https://digitalcommons.library.tmc.edu/baylor_docs/5349