title: Dislodged upper thoracic cage in the gastrointestinal tract: a case report and literature reviews.
abstract: METHODS
  A rare case of esophageal perforation secondary to a dislodged upper thoracic cage found by the gastrointestinal endoscope is presented.
  
  
  OBJECTIVE
  To report an extremely rare complication of upper thoracic vertebral tuberculosis treated with corpectomy and interbody cage surgery and suggest the cause, mechanism, and outcome of the complication of esophageal perforation.
  
  
  BACKGROUND
  Tuberculotic spondylitis often affects the anterior column of the spine and surgery is indicated in the presence of an epidural abscess, neurologic deficits secondary to compression of the spinal cord, bone destruction with instability, or failure of antituberculous therapy. Surgical treatment requires radical debridement followed by anterior stabilization. A controversy exists regarding the use of the instrumentation in the tuberculous spine.
  
  
  METHODS
  Retrospective case study and literature review.
  
  
  RESULTS
  Because of the concomitant medical problems and little deterioration of the neurologic function, our patient is managed uneventfully with conservative treatment.
  
  
  CONCLUSIONS
  To the authors' knowledge, this is an extremely rare reported complication of upper thoracic cage surgery for vertebral tuberculosis. This case demonstrates that the cage migration in the tuberculous spondylitis might have a rather benign clinical course and structural bone grafting or interbody cage insertion without supplemental instrument fixation seems to be inadequate.
authors.affiliation: Department of Orthopedic Surgery, Changhua Christian hospital, Changhua City, Taiwan. 111111@cch.org.tw
authors.forename: Chiu-Liang
authors.initials: CL
authors.lastname: Chen
authors.forename: Chii-Wen
authors.initials: CW
authors.lastname: Chou
authors.forename: Wei-Wen
authors.initials: WW
authors.lastname: Su
authors.forename: Ching-Yuan
authors.initials: CY
authors.lastname: Cheng
authors.forename: Chen-Tung
authors.initials: CT
authors.lastname: Yu
mesh_terms: D000368:Aged; D019299:Decompression, Surgical / Q000009:adverse effects / Q000295:instrumentation*; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D019736:Prostheses and Implants / Q000009:adverse effects*; D011475:Prosthesis Failure; D011859:Radiography; D012189:Retrospective Studies; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery