Delayed intracranial migration of cervical sublaminar and interspinous wires and subsequent cerebellar abscess. Case report.
Delayed complications associated with sublaminar and interspinous wiring in the pediatric cervical spine are rare. The authors present a case of delayed complication in which a cervical fusion wire migrated into the cerebellum, causing subsequent cerebellar abscess 2 years after posterior cervical arthrodesis. A craniotomy was required to remove the wire and drain the abscess. Despite their history of safety and successful fusion, procedures involving sublaminar and interspinous wiring carry a risk of neurological injury secondary to wire migration. A thorough neuroimaging evaluation is required in patients who have undergone fusion and who have neurological complaints to detect late instrumentation-related sequelae.
Department of Neurosurgery, Children's Hospital of Pittsburgh, University of Pittsburgh, Pennsylvania, USA. klstevenson@msn.com
Kevin L
KL
Stevenson
Matthew
M
Wetzel
Ian F
IF
Pollack
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001864:Bone Wires / Q000009:adverse effects*; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D002526:Cerebellar Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D005548:Foreign-Body Migration / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009254:Nafcillin / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D012086:Reoperation; D012293:Rifampin / Q000627:therapeutic use; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D010406:Penicillins; D009254:Nafcillin; D012293:Rifampin