A rare case report of laryngopharyngeal polyp formation following anterior cervical discectomy and fusion (ACDF)
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CASE REPORT
Open Access
A rare case report of laryngopharyngeal polyp formation following anterior cervical discectomy and fusion (ACDF) Xiucheng Li, Lei He, Wei He, Zuo Lv*
and Xuerong Chen*
Abstract Background: Anterior Cervical Discectomy and Fusion (ACDF) has been regarded as the “gold standard” treatment of cervical spondylosis. Though it has good outcomes, many complications still exist, such as loss of fixation, degeneration of adjacent segments, dysphagia and pharyngeal perforation. In view of current literature, this study is the first to report a case of laryngopharyngeal polyp following ACDF. Case presentation: A 63 year old male patient suffered from cervical spine hyperextension after trauma accompanied by numbness of the hands and decreased muscle strength in both upper limbs. Anterior cervical fusion surgery was performed in our hospital, after which the patient’s upper limb numbness disappeared and muscle strength returned to normal. In the fifth month after surgery, the patient developed a sore throat and dysphagia. Symptoms gradually worsened, and the patient was hospitalized four times, subsequently undergoing tracheotomy, internal fixation removal, and polypectomy. The patient’s pronunciation, breathing, and swallowing functions returned to normal, and the incision healed. After a one-year follow-up, the polyp did not recur. Conclusions: Laryngopharyngeal polyp formation following ACDF has yet to be reported in literature. By excluding esophageal fistula as soon as possible, removing internal fixation and polypectomy serves as the best treatment in relieving patient symptoms. Keywords: Laryngopharyngeal polyp, Anterior cervical discectomy and fusion (ACDF) , Esophageal fistula, Internal fixation removal, Polypectomy
Background Anterior Cervical Discectomy and Fusion (ACDF) was introduced by Smith and Robinson [1] in the 1950s. ACDF has been regarded as the “gold standard” treatment of cervical spondylosis even after half a century of its introduction [2]. ACDF has advantages in less surgical trauma, direct and thorough decompression, and effective restoration of the cervical physiological curvature. It has been widely used for treatment of fractures [3],
* Correspondence: [email protected]; [email protected] Department of Orthopaedics, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine)Shaoxing, No. 568, Zhongxing North Road, Shaoxing, Zhejiang 312000, People’s Republic of China
instability [4], tumors [5], and other cervical spine disorders. Many long-term follow-up studies have demonstrated excellent results. A 25-year follow-up study reported 81.1% of patients were free of radicular pain and had no repeated procedures. According to Odom’s criteria, 86.1% of good to excellent functional recovery was achieved [6]. After decades of surgical development, the fixation and fusion procedure as well as the materials required for ACDF have been updated and iterated. The use of plates in ACDF has shown improved clinical outcomes, fusion rates, stability and p
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