Esophageal perforation due to screw migration: A complication following C6–C7 anterior cervical fusion

A rare but fatal complication after an anterior cervical fusion procedure is implanting hardware migration. We report a case of esophageal perforation due to screw migration from the C5 level to the anterior T3 vertebral body. A 50-year-old man with cervical myelopathy and worsening motor weakness underwent anterior cervical corpectomy and fusion at C6–C7. However, he was readmitted to the hospital due to sudden tetraplegia the day after soft collar replacement. Investigations revealed screw migration from C5 to T3, accompanied by substantial subcutaneous air leakage (emphysema) due to esophageal perforation. The patient was treated conservatively with antibiotics and negative pressure drainage after refusing a surgical procedure. This case highlights the possibility of a very rare complication, esophageal perforation due to implant migration following anterior cervical fusion. Conservative therapy may be an alternative management option for esophageal perforation.