Early retropulsion of titanium-threaded cages after posterior lumbar interbody fusion: a report of two cases.
METHODS
Two patients had postoperative posterior migration of titanium fusion cages after posterior lumbar interbody fusion. They underwent a repeat posterior procedure and posterior fusion with pedicle screws.


OBJECTIVE
To suggest a treatment for posterior migration of titanium-threaded cages causing spinal stenosis after posterior lumbar interbody fusion.


BACKGROUND
The use of titanium fusion cages in posterior lumbar interbody fusion is gaining popularity as a technique for arthrodesis. The literature contains only a few reports concerning complications associated with their use.


METHODS
Two patients had retropulsion of titanium threaded cages, ten days and 2 months after posterior lumbar interbody fusion. The retropulsed cages compressing the dura, caused sudden onset of back pain and radiating pain to the lower extremities. Both patients underwent repeat posterior procedure that included repositioning of the cages and posterior fusion with pedicle screws.


RESULTS
Symptoms of back and leg pain subsided after repositioning of the cages and application of the pedicle screws.


CONCLUSIONS
A repeat posterior approach and repositioning of the retropulsed titanium fusion cages in addition to posterior fusion with pedicle screws successfully managed this complication.
Uzi
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EA
Sunnybrook and Women's College Health Science Centre, 2075 Bayview Avenue, Room MG361, Toronto, Ontario, Canada M4N 3 M5.
Dabby
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Tolessa
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Finkelstein
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JA
D000328:Adult; D005548:Foreign-Body Migration / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011859:Radiography; D012086:Reoperation; D013123:Spinal Fusion / Q000009:adverse effects*; D014025:Titanium
D014025:Titanium