An atypical infectious complication of anterior cervical surgery

We report a 44-year-old woman who developed an atypical retro-oesophageal abscess 4 years after anterior cervical surgery with fusion (ACSF). She presented with dysphagia but no fever or definite laboratory signs of inflammation. Delayed or chronic dysphagia following Cloward's operation is usually related to graft displacement. Infection may also, more rarely, be encountered in conjunction with dysphagia, but is typically associated with a classical clinical presentation and laboratory results. We recommend that in cases of delayed dysphagia without evidence of graft migration, the possibility of retropharyngeal infection should be considered, even in the absence of clinical signs or supporting laboratory evidence. MRI in this rare delayed complication is nonspecific but suggestive, and hence represents the imaging modality of choice in such situations.