Surgical neurology international最新文献

{"title":"Evaluating the accuracy of automated and semi-automated anonymization tools for unstructured health records.","authors":"Layan Abdulilah Alrazihi, Sayan Biswas, Joshi George","doi":"10.25259/SNI_459_2025","DOIUrl":"10.25259/SNI_459_2025","url":null,"abstract":"<p><strong>Background: </strong>Utilization of unstructured clinical text in research is limited by the presence of protected health identifiers (PHI) within the text. To maintain patient privacy, PHI must be de-identified. The use of anonymization tools such as Microsoft Presidio and Philter has been recognized as a potential solution to the challenges of manual de-identification. Therefore, the primary objective of this study is to evaluate the accuracy and feasibility of using Microsoft Presidio and Philter in de-identifying unstructured clinical text.</p><p><strong>Methods: </strong>A sample of 200 neurosurgical documents, temporally distributed across 10 years, was extracted. The data were processed by Microsoft Presidio and Philter. Each document was manually screened for the ground truth which was used as a reference point to evaluate the accuracy of each tool. Data analysis was conducted using Python.</p><p><strong>Results: </strong>A median of 8 PHI were manually de-identified per document. Both tools were individually capable of de-identifying a median of 6 PHI per document. Each tool de-identified PHI with an accuracy of 96%. Presidio demonstrated precision of 0.51 and a recall of 0.74, while Philter had precision and recall of 0.35 and 0.79, respectively.</p><p><strong>Conclusion: </strong>The performance of each tool supports their use in anonymizing unstructured clinical text. Formatting variations between texts limited the performance of both tools. To conclude, further research is required to optimize the tools' output and assess the reliability in de-identifying diverse and previously unseen clinical text, thus allowing the use of unstructured clinical text in medical research.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"313"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological profile of adult primary brain tumors.","authors":"Fawaz Assaad, Asem Salma, Manar Mrad","doi":"10.25259/SNI_280_2025","DOIUrl":"10.25259/SNI_280_2025","url":null,"abstract":"<p><strong>Background: </strong>The study was carried out to explore the epidemiologic profile of the incidence of primary brain tumors (PBTs) in Syria.</p><p><strong>Methods: </strong>A prospective and observational study was conducted in all neurosurgical departments of primary referral hospitals across Syria's 14 districts during 2009^th study was conducted in all neurosurgical department PBTs were included, with diagnoses based on either histopathological confirmation or characteristic radiological features. Incidence rates were age-adjusted to the 2004 Syrian standard population.</p><p><strong>Results: </strong>A total of 2,994 cases (1,532 males and 1,462 females) were identified. The average annual incidence rate of PBTs was 7.48/100,000 person-years, with gliomas (3.36), meningiomas (1.43), and sellar region tumors (1.25) being the most common. Meningiomas showed a female predominance (female: male = 1.6:1), while gliomas were more common in males (male: female = 1.3:1). The median age at the diagnosis was 52 years overall, 56 years for neuroepithelial tumors, and 48 years for meningiomas.</p><p><strong>Conclusion: </strong>The epidemiology of brain tumors in Syria shows a relatively low incidence, with differences in age and tumor distribution by sex. These findings establish a critical pre-conflict baseline for Syria and highlight potential under the diagnosis despite a functioning health infrastructure.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"310"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large skull base involvement of rhino-orbital-cerebral mucormycosis with rapidly progressive onset in immunocompetent patient mimicking a sphenoid meningioma.","authors":"Haifaa Mechergui, Sofiene Bouali, Asma Bouhoula, Nesrine Nessib, Khalil Ghedira, Khansa Abderrahmen","doi":"10.25259/SNI_132_2025","DOIUrl":"10.25259/SNI_132_2025","url":null,"abstract":"<p><strong>Background: </strong>Invasive skull base of rhino-orbital-cerebral mucormycosis is rare, rapidly progressive, and potentially life-threatening disease, and it usually occurs in immunocompromised patients. We are witnessing an unprecedented peak of rhino-cerebral mucormycosis since the second wave of the Coronavirus Disease-2019 pandemic.</p><p><strong>Case description: </strong>A 31-year-old man experienced a sudden onset of decreased visual acuity associated with right exophthalmos and paroxysmal headache that had been ongoing for 2 months before his presentation. On examination, he presented a frontal syndrome with preserved eye movement, with vision impairment, and with bilateral stage 3 papilledema. In addition, the patient is feverish, and the general examination showed no lesion of the nose or skin. All biological investigations were done and were negative, even a COVID-19 test. Brain magnetic resonance imaging revealed a right extra-axial temporal lesion that was isointense on T1-weighted imaging, hypointense on T2-weighted imaging, and well enhancing with gadolinium. The lesion extended into the orbit, cavernous sinus (involving the optic nerve and internal carotid artery), and the infratemporal fossa, suggestive of a sphenoidal meningioma. The patient underwent subtotal resection. Postoperatively, the patient remained feverish, and his condition was worsening. He died 6 days after the surgery. A brain infection was impossible to diagnose until after his death. The anatomopathological examination confirmed mucormycosis.</p><p><strong>Conclusion: </strong>The findings from the present case indicate that a large intracranial mass is an uncommon clinical characteristic of cerebral mucormycosis in an immunocompetent patient. It can manifest with the classic symptoms of large temporal spheno-orbital invasive meningiomas. To the best of our knowledge, very few studies are reported depicting the patterns of skull base involvement and associated neurological implications of patients with skull base involvement of rhino-orbital-cerebral mucormycosis along with its clinical, radiological, intraoperative, and post-operative correlates.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"314"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case of fatal cerebellar hemorrhage following lumbar spinal surgery with dural leak.","authors":"Hiroki Narita, Michihisa Narikiyo, Yusuke Hirokawa, Rento Miyazaki, Kohei Yamamoto, So Ohashi, Hirokazu Nagasaki, Yoshifumi Tsuboi, Hidenori Matsuoka","doi":"10.25259/SNI_608_2025","DOIUrl":"10.25259/SNI_608_2025","url":null,"abstract":"<p><strong>Background: </strong>Remote cerebellar hemorrhages are more commonly reported after supratentorial surgeries, but rarely occur after spinal procedures, particularly those involving a cerebrospinal fluid leak/dural tear (DT).</p><p><strong>Case description: </strong>For L3-L5 lumbar stenosis and L4/5 grade I spondylolisthesis, a 64-year-old female underwent a L3/4 XLIF (extreme lateral lumbar interbody fusion) and L4/5 posterior lumbar interbody fusion (PLIF with pedicle screw fixation). Notably, during the PLIF, there was likely a traumatic DT (i.e., likely unrecognized at the time or not repaired); mistakenly, the surgeons applied a drain using maximal negative pressure. Within 8 postoperative h, the patient developed a severe headache and rapid neurological deterioration. The brain computed tomography revealed bilateral cerebellar hemorrhages with tonsillar herniation. Despite an emergent suboccipital craniotomy for hematoma evacuation, the patient expired on postoperative day 13.</p><p><strong>Conclusion: </strong>Here, a 64-year-old female underwent a L3/4 XLIF combined with L4/5 PLIF for L3-5 stenosis with grade I L4/5 spondylolisthesis. An unrecognized and/or untreated DT likely occurred during the L4/5 PLIF, leading to the mistaken placement of a \"maximal negative pressure drain.\" Within 8 postoperative h, she developed a severe headache and acute neurological deterioration. Although she underwent emergent surgery for bilateral cerebellar hemorrhages, which were responsible for her sudden neurological worsening, she died 13 days later.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"312"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infectious intracranial aneurysm caused by infective endocarditis following buccal fat pad removal - An esthetic plastic procedure.","authors":"Hiroyuki Koizumi, Daisuke Yamamoto, Kohei Uemasu, Yasushi Asari, Tosihiro Kumabe","doi":"10.25259/SNI_582_2025","DOIUrl":"10.25259/SNI_582_2025","url":null,"abstract":"<p><strong>Background: </strong>The demand for cosmetic treatments in Japan is increasing, especially among young adults, yet rare but serious infectious complications related to esthetic plastic surgery (APS) remain underrecognized. To address this gap, we report a case of an infectious intracranial aneurysm (IIA) caused by infective endocarditis (IE) following buccal fat pad (BFP) removal, a type of APS.</p><p><strong>Case description: </strong>A 25-year-old woman presented with fever and impaired consciousness. The patient had previously undergone BFP removal through an intraoral incision for cosmetic purposes 8 weeks ago. Transthoracic ultrasonography revealed vegetation (>17 mm) on the anterior mitral leaflet with mitral regurgitation, confirmed by transesophageal echocardiography. Blood cultures identified <i>Abiotrophia defectiva</i>, a common oral flora. Computed tomography angiography revealed a newly developed, unruptured IIA in the right middle cerebral artery (7 × 5 mm). The patient was transferred to our hospital for mitral valve repair. To minimize the risk of aneurysm rupture during surgery using cardiopulmonary bypass, we first performed coil embolization followed by mitral valve repair. The patient recovered without neurological deficits.</p><p><strong>Conclusion: </strong>This case highlights a previously unrecognized but important clinical issue: IIA caused by IE can occur after APS. Neurosurgeons and esthetic plastic surgeons should be aware that infectious aneurysms represent a significant potential complication of APS.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"319"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of post-craniotomy cerebral hemodynamic by transcranial Doppler.","authors":"Lotfi Rebai, Wissal Nsiri, Firas Kalai, Sabrine Ben Brahem, Olfa Faten, Ichraf Ardhaoui","doi":"10.25259/SNI_423_2025","DOIUrl":"10.25259/SNI_423_2025","url":null,"abstract":"<p><strong>Background: </strong>Craniotomy for supratentorial tumor resection can alter cerebral hemodynamics, potentially leading to post-operative complications. Transcranial color-coded duplex sonography (TCCD) provides a noninvasive method for evaluating cerebral perfusion and predicting outcomes. The objective of this study was to assess the prognostic value of TCCD parameters, particularly pulsatility index (PI) and diastolic velocity (DV), in predicting post-operative complications following elective craniotomy for supratentorial tumor resection.</p><p><strong>Methods: </strong>This prospective, observational study included 48 adult patients undergoing supratentorial tumor resection. TCCD was performed preoperatively and postoperatively to measure PI, systolic velocity (SV), DV, and mean velocity (MV). Patients with signs of intracranial pressure hypertension (high) were identified based on clinical and radiological parameters. Post-operative clinical and radiological complications were recorded. ROC curve analyses were performed to determine the predictive value of transcranial Doppler parameters.</p><p><strong>Results: </strong>Post-operative SV and MV significantly increased compared to pre-operative values (<i>P</i> = 0.008 and <i>P</i> = 0.037, respectively), while PI and DV remained stable. Pre-operative elevated PI and decreased DV were significantly associated with post-operative complications, including delayed awakening and ischemia. Postoperative PI predicted ischemia with an area under the curve (AUC) of 0.86 and delayed awakening with an AUC of 0.89. Lower DV values were predictive of seizures, ischemia, and delayed awakening. Elevated PI and reduced DV correlated with longer intensive care unit stays.</p><p><strong>Conclusion: </strong>TCCD is a valuable, non-invasive tool for early identification of patients at risk for post-operative complications following craniotomy for tumor resection. Monitoring PI and DV may guide post-operative management and improve outcomes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"308"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-operative fluoroscopy exposure in endoscopic lumbar discectomies.","authors":"Panagiotis Tsipouriaris, Ioannis Panagiotis Athinodorou, Fotios Efthymiou, Vasileios I Metaxas, Christos Dimitroukas, Angelos Constantoyannis, George Panayiotakis, Constantine Constantoyannis","doi":"10.25259/SNI_523_2025","DOIUrl":"10.25259/SNI_523_2025","url":null,"abstract":"<p><strong>Background: </strong>Spinal endoscopic procedures require the use of fluoroscopy to guide the placement of the instrumentation. This results in exposure to ionizing radiation of both medical staff and patients. This study aimed to evaluate the radiation doses during endoscopic lumbar discectomies in our institution.</p><p><strong>Methods: </strong>From July 2023 to February 2024, 54 patients with lumbar spine disc herniations were operated on by a single surgeon; operations included using a mobile C-arm to perform interlaminar endoscopic lumbar discectomy (IELD, <i>n</i> = 18) or transforaminal endoscopic lumbar discectomy (TELD, <i>n</i> = 36). For each procedure, the following variables were analyzed: patient-related (age, gender, weight, and body mass index) and radiation-related data (fluoroscopy time [FT], tube voltage [kVp], kerma-area product [KAP], and cumulative air-kerma [CAK]).</p><p><strong>Results: </strong>Patients' age, procedural duration, number of cine acquisitions, and all radiation-related metrics (FT, KAP, CAK) demonstrated a significant difference between the two groups examined. Skin doses in both groups were well below the safe threshold. The mean age of the total sample was 52.27 years. The mean kVp was 103.44 for IELD group and 95.69 for TELD group. The mean KAP was 8.18 dGycm² for IELD group and 29.09 dGycm² for TELD group. CAK was 4.72 mGy for IELD group and 15.87 mGy for TELD group. The mean FT was 18.72 s for IELD group and 54.94 s for TELD group.</p><p><strong>Conclusion: </strong>Intra-operative fluoroscopy results in a relatively low radiation dose during endoscopic discectomy procedures. We found comparable radiation dose data between both endoscopic techniques (IELD and TELD). However, transforaminal techniques require more FT and it is a more demanding procedure.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"305"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal carotid artery dissection presenting with glossopharyngeal nerve dysfunction: A case report.","authors":"Tomoya Sofue, Megumi Chatani, Hiroyuki Ohnishi","doi":"10.25259/SNI_528_2025","DOIUrl":"10.25259/SNI_528_2025","url":null,"abstract":"<p><strong>Background: </strong>Internal carotid artery dissection (ICAD) is an uncommon but important cause of ischemic stroke in young adults, particularly in Asian populations where its incidence is relatively low. While ICAD typically presents with headache, neck pain, or ischemic symptoms, it can also lead to isolated cranial nerve involvement, complicating the diagnostic process.</p><p><strong>Case description: </strong>We report the case of a 45-year-old woman who presented with isolated right-sided glossopharyngeal nerve symptoms - specifically, ageusia and pharyngeal discomfort - along with mild posterior neck pain. Initial evaluation by otolaryngology failed to identify the etiology. Subsequent imaging at our hospital revealed a spontaneous dissection of the right internal carotid artery extending from the third cervical spinal cord level to the proximal petrous segment. Magnetic resonance angiography and digital subtraction angiography confirmed the diagnosis of ICAD. Conservative management with antiplatelet therapy (aspirin 100 mg/day) led to symptom improvement, and follow-up imaging after 180 days demonstrated near-complete resolution of the dissection.</p><p><strong>Conclusion: </strong>This case is noteworthy due to the absence of cerebral ischemic findings and the isolated involvement of the glossopharyngeal nerve, likely due to localized anterolateral expansion of the dissection cavity compressing the pharyngeal branch of the nerve. Although mild styloid process elongation was observed, there was no radiological evidence suggesting Eagle syndrome. This case emphasizes the importance of considering ICAD in the differential diagnosis of lower cranial nerve palsies, even in the absence of stroke or typical neurological signs.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"304"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous spinal epidural hematoma mimicking acute coronary syndrome: A case report and literature review.","authors":"Kivanc Yangi, Omar Alomari, Haydar Gök","doi":"10.25259/SNI_490_2025","DOIUrl":"10.25259/SNI_490_2025","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous spinal epidural hematoma (SSEH) is a rare neurological emergency that can mimic acute myocardial infarction due to overlapping symptoms such as chest and back pain. Misdiagnosis may lead to inappropriate treatments such as anticoagulation, potentially worsening the patient's condition.</p><p><strong>Case description: </strong>We report a 64-year-old woman with hypertension and a history of breast cancer who presented with chest and upper back pain, accompanied by left arm numbness. Mildly elevated troponin levels led to an initial diagnosis of acute coronary syndrome (ACS). Brain imaging was unremarkable, and coronary angiography revealed normal vessels. However, progressive left-sided hemiparesis and urinary retention prompted cervical magnetic resonance imaging, which revealed a subacute epidural hematoma at the C5-C7 level. Urgent decompressive hemilaminotomy was performed, resulting in gradual neurological recovery. By postoperative day 10, the patient had regained full motor strength.</p><p><strong>Conclusion: </strong>This case underscores the diagnostic challenges of SSEH presenting with atypical chest symptoms. Clinicians should maintain a high index of suspicion for spinal pathology in patients with axial pain and evolving neurological deficits, even when initial cardiac evaluations are suggestive of ACS. Timely spinal imaging is critical to avoid harmful interventions and enable prompt surgical treatment.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"306"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed presentation of esophageal perforation from anterior cervical discectomy and fusion hardware failure in a patient presenting with non-ST-elevation myocardial infarction: An illustrative technical note.","authors":"Tyler Nicole Lackland, Mayur Patel, Kathleen Suzann Botterbush, Joseph J Platz, Mauricio J Avila","doi":"10.25259/SNI_242_2025","DOIUrl":"10.25259/SNI_242_2025","url":null,"abstract":"<p><strong>Background: </strong>A 69-year-old male, who underwent a C5-T1 ACDF 5-years prior to arrival, presented with a ventral pharyngeal abscess and esophageal perforation warranting major gastro-esophageal surgery and instrumentation removal.</p><p><strong>Methods: </strong>The case of a patient who underwent a C5-T1 ACDF five years ago was reviewed. A review of past reports of cases of patients who experienced esophageal erosion or perforation following ACDF was conducted.</p><p><strong>Results: </strong>At the age of 69, the patient acutely developed disorientation/agitation and urinary/fecal incontinence. Lab studies showed leukocytosis, an elevated creatine phosphokinase (CPK), and lactic acidosis, while the EKG confirmed a non-ST-elevation myocardial infarction (NSTEMI) with increased troponins. An esophagram revealed esophageal perforation, and a prevertebral C5-C6 abscess, and neck/thoracic CT studies documented 8-9 mm anterior displacement of the right inferior C7 screw with extravasation extending inferiorly into the mediastinum. Surgery consisted of an esophagogastroduodenoscopy, gastric/jejunal tube placement, left neck exploration, and dissection of the esophagus off the anterior instrumentation that was subsequently removed. Despite emergent surgical intervention, the patient expired 5 days postoperatively.</p><p><strong>Conclusion: </strong>Neurosurgical follow-up is warranted in ACDF patients who newly present with findings indicative of with anterior retropharyngeal abscess or esophageal perforation.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"299"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}