title: Late spinal cord compression caused by pulled-out thoracic pedicle screws: a case report.
abstract: METHODS
  A case report.
  
  
  OBJECTIVE
  To report a late neurologic compromise caused by pulling-out of thoracic pedicle screws.
  
  
  BACKGROUND
  Although screw misplacement is quite common, only few neurologic injuries have been reported because of penetration of the medial wall of pedicles in the thoracic spine. To our knowledge, neurologic compromise caused by pulling-out of the screws has not been reported to date.
  
  
  METHODS
  A 6-year-old girl with congenital muscle fiber type disproportion was posteriorly instrumented (T3 to L4) for severe kyphosis. Later, she had a junctional kyphosis over the top of the instrument. Her instrumentation was lengthened to T2 by using transpedicular screws. During the follow-up period, T2 screws were pulled-out and intruded into the canal, causing neurologic compromise. The presenting symptoms, imaging studies, and related literature are reviewed in this report.
  
  
  RESULTS
  Patient's neurologic symptoms subsided after removal of the pedicle screws intruded into the spinal canal.
  
  
  CONCLUSIONS
  Pulling-out of transpedicular screws inserted at T1 or T2 where the pedicles are oriented more medially may cause late neurologic compromise caused by intrusion of triangulated screws into the spinal canal.
authors.affiliation: University Faculty of Medicine, Department of Orthopaedics & Traumatology, Spine Unit, Ankara, Turkey. alanay@superonline.com
authors.forename: Ahmet
authors.initials: A
authors.lastname: Alanay
authors.forename: Akin
authors.initials: A
authors.lastname: Cil
authors.forename: Emre
authors.initials: E
authors.lastname: Acaroglu
authors.forename: Omur
authors.initials: O
authors.lastname: Caglar
authors.forename: Rahmican
authors.initials: R
authors.lastname: Akgun
authors.forename: Salih
authors.initials: S
authors.lastname: Marangoz
authors.forename: Muharrem
authors.initials: M
authors.lastname: Yazici
authors.forename: Adil
authors.initials: A
authors.lastname: Surat
mesh_terms: D001863:Bone Screws / Q000009:adverse effects*; D002648:Child; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000601:surgery; D013115:Spinal Canal / Q000000981:diagnostic imaging; D013117:Spinal Cord Compression / Q000209:etiology*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed