Vomiting and Dysphagia Due To Fractured of Allograft After Anterior Cervical Discectomy and Fusion

Abstract

Anterior cervical discectomy and fusion (ACDF) is commonly performed for cervical disk disease. Establishing Fibular allograft after discectomy is frequently applied. A variety of complications may occur such as dysphagia, dyspnea, bilateral vocal cord paralysis, recurrent laryngeal nerve paralysis, internal juguler venous thrombosis, cervical screw extrusion, bone graft extrusion, vascular injury and epidural hematoma. Dysphgia is the most common complication after ACDF and its etiology is still obscure. It usually improves in 6 months, but remains as a significant problem for some patients. Graft extrusion is a well -recognized complication. We present the case of 44 - year - old woman with dysphagia and persistent vomiting due to collapsed fibula allograft. She had undergone anterior C 5-6 discectomy and fusion with fibula allograft at our institute 7 months before. Her lateral cervical radiography showed collapsed fibula allograft, which was extruded toward the esophagus, at cervical 5-6 level. Fractured bone graft was removed by anterior cervical approach. After surgery, the patient's complaints were improved. Dysphagia has been very frequently reported due to various causes after ACDF. Whereas, feeling of nausea and vomiting have never been reported. Also extrusion or collapse of bone graft following ACDF has rarely been reported.