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Gastroenterology (Expert Forum)
Swallow problem, & broken plate, Post Cervical Fusion
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Swallow problem, & broken plate, Post Cervical Fusion
by Tricia-, Nov 03, 1998 12:00AM
HISTORY
Had C4-5, C5-6 cervical fusion in 94. Included cowbone graft at 2 levels, + titanium AO locking plate.
Have had ongoing swallowing problems since the surgery. Also throat discomfort & pain (throat/neck area) after walking, talking, & when overly tired.
In 96, the titanium plate was seen on X-ray... broken in half.
The distal end of the plate is tilting into the oesophagus.
MRI also revealed osteophyte growth from the bone graft at the 2 levels of fusion. Encroaching the subarachnoid space.
Successful fusion is consequently being questioned.
I recently had a barium swallow. Video of this swallow indicated the plate was pressing into the oesophagus causing some constriction. The plate is still being held by screws but has moved down due to the collapsed cowbone graft, & the spine shortening.
I have had conflicting opinion as to removal of this plate. All but a Gastroenterologist have stated this plate can be left in-situ without concern. Due to these reports I have had no further surgical intervention. My Neurosurgeon has dismissed me from his care & will not touch it. I am being managed by my GP who requests yrly radiographic monitoring. I am concerned that if I don't have this plate removed soon the outcome for me could be serious in terms of oesophageal perforation. I am very nervous driving my car...anticipating a deathly whiplash inj.
OUESTION
Are my concerns reasonable?
Would it be unwise to leave this broken plate untouched?
Do research studies indicate oesophageal problems following failed cervical fusion? Particularly where broken instrumentation is a factor.
Can these cervical graftbone osteophytes impact on swallowing?
___________
Dear Tricia,
Compression of the esophagus (by osteophytes, tumor, foreign bodies) can cause difficulty swallowing because the sopahgus can not distent. Extrinsic compression does not usually cause perforation of the esophagus except forreports of osteophyte-induced perforation during endoscopy. I can not comment on the risk of broken instrumentation because I have not had patients with this problem. Assuming that there are no sharp edges, I would not anticipate any problems.
This inform,ation is presented for educational purposes only. Always ask specific questions to your personal physician.
HFHSM.D.-rf
*keywords: dysphagia, esophagus
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