gms | German Medical Science

Objective: Cervical spondylodiscitis in association with an esophageal fistula is a rare but life threatening disease. Due to the rarity of this kind of inflammatory focus there is no gold standard for the optimal treatment and management. There are only a few individual cases reported in the literature. We present a case series of eight patients suffering from cervical spondylodiscitis with an associated esophageal fistula.

Methods: A retrospective analysis between January 2010 and July 2017 was performed. Patients with cervical spondylodiscitis and an underlying esophageal fistula were included. We assessed clinical findings, treatment and outcome.

Results: Out of 46 patients suffering from cervical spondylodiscitis between January 2010 and July 2017, 8 patients (17.4 %; 5 male, 3 female) had a concomitant esophageal fistula. Mean age at presentation was 63 years (range 32- 81 years). At time of admission to our department four patients presented with tetraparesis or tetraplegia and four patients had pain but were neurologically intact. Five patients had an anterior debridement and an additional dorsal instrumentation, three patients received a posterior approach only.

Two patient died during hospital stay and three patients were transferred to a palliative care unit. At discharge two patients remained neurologically intact, one patient remained with a tetraparesis ASIA B.

Conclusion: Cervical spondylodiscitis in association with an esophageal fistula is a rare but life threatening complication. An interdisciplinary and individual management including surgical treatment of discitis and fistula should be considered in every case.