title: Late complications of displaced thoracolumbar fusion instrumentation presenting as new pain in individuals with spinal cord injury.
abstract: BACKGROUND
  Harrington rods and more modern thoracolumbar posterior fusion with segmental instrumentation have been used successfully for decades in individuals with scoliosis or spinal cord injury (SCI). However, late complications of these instrumentations specifically presenting as new, localized pain in individuals with SCI have not been previously reported. Displacement of the hooks and the rods can cause significant back pain that may require hardware removal.
  
  
  METHODS
  Two case reports illustrate thoracolumbar fusion rod removal because of displaced hooks with protruding rods and associated pain.
  
  
  RESULTS
  Both of the individuals experienced back pain caused by proximal hook displacement. There was no neurologic deterioration. The proximal portions of the rods were sawed off and the displaced hooks and the rods were removed.
  
  
  CONCLUSIONS
  These cases illustrate the importance of clarifying different types of pain experienced by individuals with SCI and the importance of diagnosing the cause of pain accurately.
authors.affiliation: Santa Clara Valley Medical Center, Department of Physical Medicine and Rehabilitation, 751 South Bascom Avenue, San Jose, CA 95128, USA. Kazuko.Shem@hhs.co.Santa-Clara.ca.us
authors.forename: Kazuko L
authors.initials: KL
authors.lastname: Shem
mesh_terms: D000328:Adult; D001416:Back Pain / Q000209:etiology*; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices / Q000009:adverse effects*; D013119:Spinal Cord Injuries / Q000150:complications / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography