Conclusions
Chyle leaks can occur intraoperatively or become evident months after ACDF. Three cases have reported, with an incidence of <0.001%. These all occurred after surgery at the C5-6 level and a left sided approach. They present as lower neck swelling and pain. These can be treated postoperatively with needle drainage if small or open ligation of the thoracic duct if severe. Patients can experience a full recovery.