Cervical edema after anterior cervical fusion, a rare but potentially fatal complication: a case report

Anterior approaches to the cervical spine can be performed for spine decompression and instrumentation in many pathologic conditions. Cervical spine surgeries complicate in 5.3% of cases, with anterior procedures representing 65% of them. Airway compromise requiring tracheostomy or reintubation is rare but may lead to potentially catastrophic complications. There are several causes for airway compromise, including post-operative cervical swelling or hematoma, pharyngeal edema, cerebrospinal fluid (CSF) leak, angioedema, and graft or implant displacement. We present a case of a 57-year-old male with chronic neck and left radicular pain. He was submitted to C5-C6 anterior cervical disc fusion that was complicated with airway compromise in the orthopedics ward. The patient required emergent reintubation for airway protection, wound exploration and intensive care. Hematoma is often the first diagnosis to consider in the immediate postoperative period. A low threshold for intubation should be maintained. After airway protection, it is essential to differentiate etiologies, to guide subsequent management.