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Background Esophageal fistula is a very rare complication associated with anterior approaches to the cervical spine. Timely diagnosis and early intervention are associated with favorable outcomes. There is a dilemma in the literature for its optimal management. In this review article, we will discuss the management dilemmas in patients with esophageal perforation along with an illustrative case. Material and Methods A 24-year-old male patient operated for C5–6 fracture dislocation, presented with esophageal fistula 1 month after surgery. Investigations were done to localize the site of fistula but definitive site of leak could not be identified. Patient was counselled regarding possible surgical intervention; however, patient was opted for conservative treatment. Conclusion Esophageal fistula is a very rare occurrence. Because of varied clinical presentation and frequent delay in diagnosis, a very high index of suspicion should always be kept in mind while evaluating a patient postoperatively for dysphagia. Timely diagnosis and early intervention are key to a successful outcome.

Esophageal Fistula following Anterior Cervical Discectomy and Fusion in Traumatic Cervical Injury Cases: A Review